JP2015528001A - Composition comprising HC-HA / PTX3 complex and method of use thereof - Google Patents

Abstract

Provided herein is a method for producing a natural reconstituted hyaluronan (HA) complex comprising pentraxin 3 (PTX3) and heavy chain 1 (HC1) of an inter-alpha inhibitor (IαI). Compositions comprising the complexes and methods of treatment using the complexes are provided. Combinations and kits used in carrying out the method are also provided. [Selection] Figure 3

Description

(Cross-reference to related applications)
This application claims the benefit of US Patent Application No. 61 / 670,571, filed June 11, 2012, which is incorporated herein by reference in its entirety.

(Report on research or development supported by the federal government)
Financial assistance for the work described herein is partly from the National Ophthalmology Institute of Bethesda, Maryland, US Federal Research Grants RO1 EY06819, R44 EY017497, and R43 EY021045 from the National Institutes of Health. offered.

(EFS-incorporation by citation of sequence listing submitted as text file via web)
This application includes a sequence listing, which has been submitted as a computer readable text file in ASCII format by EFS-Web and is hereby incorporated by reference in its entirety. The text file created on July 8, 2013 is 34157-732-601SEQ. It is named txt and is 462 KB in size.

  The amniotic membrane (AM) is an avascular membranous sac filled with amniotic fluid surrounding the fetus. AM, like the placenta, is derived from the upper blastoderm layer that forms during the development of a fertilized egg. AM forms the innermost membrane that surrounds the fetus in the amniotic cavity. In placental mammals, the umbilical cord (ie, the umbilical cord) connects the developing fetus to the placenta. The umbilical cord is composed of amniotic membrane (UCAM) and Walton jelly. The amniotic membrane forms the outer layer of the umbilical cord. UCAM functions to regulate the fluid pressure within the UC. Walton jelly is a gelatinous substance inside the umbilical cord composed mainly of mucopolysaccharides (hyaluronic acid and chondroitin sulfate). This also includes some fibroblasts and macrophages. The umbilical cord further includes two arteries (umbilical artery) and one vein (umbilical vein) embedded in the Walton Jelly.

  Described herein is a method for identifying HC-HA / PTX3 complexes in fetal tissues such as amniotic membrane and umbilical cord. Further described herein is a method for isolating native HC-HA / PTX3 complexes from fetal tissues such as amniotic membrane and umbilical cord. Further described herein is a method for producing a reconstituted HC-HA / PTX3 complex. Further provided herein are methods for the use of the naturally reconstituted HC-HA / PTX3 complex provided herein as provided herein.

  Described herein are methods for producing HC-HA / PTX3 complexes in certain embodiments. In some embodiments, the method comprises isolating a native HC-HA / PTX3 (nHC-HA / PTX3) complex from an extract prepared from tissue or cells. In some embodiments, the method includes generating a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex.

  Described herein, in certain embodiments, are methods for separating native HC-HA / PTX3 (nHC-HA / PTX3) complexes from amniotic tissue such as umbilical cord or amniotic membrane. In some embodiments, the nHC-HA / PTX3 complex is isolated from the isolated cell. In some embodiments, the nHC-HA / PTX3 complex is isolated from cultured cells. In some embodiments, the nHC-HA / PTX3 complex is isolated from stem cells. In some embodiments, the nHC-HA / PTX3 complex is isolated from an aqueous fraction of an extract prepared from tissues such as umbilical cord or amniotic membrane. In some embodiments, the water soluble fraction is extracted with an isotonic salt solution. In some embodiments, the nHC-HA / PTX3 complex is separated from the water-insoluble fraction of the extract prepared from tissues such as umbilical cord or amniotic membrane. In some embodiments, the water-insoluble fraction is extracted with GnHCl.

Described herein, in certain embodiments, is a method of generating HC-HA / PTX3 reconstituted in vitro (rcHC-HA / PTX3) comprising: (a) PTX3 and In order to form an HMW HA immobilized complex (immobilized PTX3 / HA), (i) high molecular weight hyaluronan (HMW HA) immobilized on a solid support and (ii) pentraxin 3 (PTX3) Contacting the protein, and (b) stimulated with an inter-alpha inhibitor (IαI) protein comprising heavy chain 1 (HC1) and tumor necrosis factor α to form an immobilized rcHC-HA / PTX3 complex The immobilized gene 6 (TSG-6) is contacted with immobilized PTX3 / HA. In some embodiments, steps (a) and (b) of the method are performed sequentially in sequence. In some embodiments of the method, the method comprises pentraxin 3 (PTX3) protein, inter-alpha inhibitor (IαI) protein comprising heavy chain 1 (HC1), and gene 6 (TSG-6) stimulated with tumor necrosis factor α. ) Includes a step of simultaneously contacting high molecular weight hyaluronan (HMW HA). In some embodiments of the method, TSG-6 catalyzes the covalent binding of IαI HCl to HA. In some embodiments, the method further comprises removing unbound PTX3 protein after step (a) and before performing step (b). In some embodiments, the method further comprises removing unbound TSG-6 after step (b). In some embodiments, the PTX3 protein used in the method is a native PTX3 protein isolated from cells. In some embodiments, the cell is a mammalian cell. In some embodiments, the cell is a human cell. In some embodiments, the cell is an amniotic cell. In some embodiments, the cells are umbilical cord cells. In some embodiments, the cell is an amniotic cell from the umbilical cord. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, the PTX3 protein is a recombinant protein. In some embodiments, the PTX3 protein used in the method is at least 75% relative to a polypeptide having the sequence of SEQ ID NO: 33 or a polypeptide having the sequence set forth in SEQ ID NO: 33 , 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% polypeptide having amino acid sequence identity. In some embodiments, the PTX3 protein used in the method is a polypeptide having a sequence specified in any of SEQ ID NOS: 32-45, or a species variant or allelic variant thereof. Has an allivariant. In some embodiments, the PTX3 protein used in the method is a multimeric protein. In some embodiments, the PTX3 protein used in the method is a homomultimer (ie, a multimeric protein consisting of two or more identical components). In some embodiments, the PTX3 homomultimer is a dimer, trimer, tetramer, pentamer, hexamer, or octamer. In some embodiments, the PTX3 homomultimer is an octamer. In some embodiments, the PTX3 protein comprises a modified multimerization domain or a heterologous multimerization domain. In some embodiments, the TSG-6 protein used in the method is a native TSG-6 protein isolated from cells. In some embodiments, the cell is a mammalian cell. In some embodiments, the cell is a human cell. In some embodiments, the cell is an amniotic cell. In some embodiments, the cells are umbilical cord cells. In some embodiments, the cell is an amniotic cell from the umbilical cord. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, the TSG-6 protein is a recombinant protein. In some embodiments, the TSG-6 protein is at least 75% relative to a polypeptide having a sequence specified by SEQ ID NO: 2, or a polypeptide having a sequence specified by SEQ ID NO: 2. , 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% polypeptide having amino acid sequence identity. In some embodiments, the TSG-6 protein used in the method comprises a polypeptide having a sequence specified in any of SEQ ID NOS: 1-31, or a species variant or allelic variant thereof. Including. In some embodiments, the HC1 used in the method is at least relative to a polypeptide having a sequence specified by SEQ ID NO: 47 or a polypeptide having a sequence specified by SEQ ID NO: 47. Polypeptides having 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity are included. In some embodiments, the inter-alpha inhibitor (IαI) protein used in the method as a source of HC1 also includes HC2 and bikunin bound by a chondroitin sulfate chain. In some embodiments, HC1 comprises a polypeptide having a sequence specified in any of SEQ ID NOS: 46-47, or a species variant or allelic variant thereof. In some embodiments, HC2 is at least 75%, 80% of a polypeptide having a sequence specified by SEQ ID NO: 49, or a polypeptide having a sequence specified by SEQ ID NO: 49. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. In some embodiments, the HC2 used in the method comprises a polypeptide having a sequence specified in any of SEQ ID NOS: 48-49, or a species variant or allelic variant thereof. In some embodiments, bikunin is at least 75%, 80% relative to a polypeptide having a sequence specified as SEQ ID NO: 53, or a polypeptide having a sequence specified as SEQ ID NO: 53. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. In some embodiments, the bikunin used in the method comprises a polypeptide having a sequence specified in any of SEQ ID NOS: 52-53, or a species variant or allelic variant thereof. In some embodiments, the IαI protein used in the method is isolated from blood, serum, plasma, amniotic membrane, chorion, amniotic fluid, or a combination thereof. In some embodiments, the IαI protein used in the method is isolated from serum. In some embodiments, the IαI protein used in the method is isolated from human serum. In some embodiments, the IαI protein used in the method is produced by a mammalian cell. In some embodiments, the cell is a mammalian cell. In some embodiments, the cell is an amniotic cell. In some embodiments, the cells are umbilical cord cells. In some embodiments, the cell is an amniotic cell from the umbilical cord. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, the IαI and TSG-6 proteins are 1: 1, 2: 1, 3: 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, 9: Contact at a molar ratio of 1, 10: 1, 15: 1, or 20: 1. In some embodiments, the IαI and TSG-6 proteins are contacted at a 3: 1 molar ratio. In some embodiments of the method, the weight average molecular weight of the HMW HA is between about 500 kDa and about 10,000 kDa, between about 800 kDa and about 8,500 kDa, between about 1100 kDa and about 5,000 kDa, or It is between about 1400 kDa and about 3,500 kDa. In some embodiments of the method, the weight average molecular weight of HMW HA is 3,000 kDa. In some embodiments, the HMW HA is immobilized by direct binding to a solid support. In some embodiments of the method, the HMW HA is immobilized by indirect binding to a solid support. In some embodiments of the method, the HMW HA is covalently immobilized to a solid support. In some embodiments of the method, the HMW HA is immobilized non-covalently to a solid support. In some embodiments of the method, the HMW HA is immobilized by binding to a solid support via a cleavable linker. In some embodiments, the linker is a chemically or enzymatically cleavable linker. In some embodiments, the method comprises dissociation of the rcHC-HA / PTX3 complex from the solid support after step (b). In some embodiments, dissociating includes cleavage of a cleavable linker. In some embodiments, the method comprises purifying the separated rcHC-HA / PTX3 complex. In some embodiments, purification includes affinity purification, centrifugation, filtration, chromatography, or a combination thereof. In some embodiments of the method, the PTX3, IαI HC1, or TSG-6 polypeptide comprises an affinity tag. In some embodiments, the affinity tag is selected from a hemagglutinin tag, a poly-histidine tag, a myc tag, a FLAG tag, a glutathione-S-transferase (GST) tag. In some embodiments, the HMW HA is immobilized by binding the HMW HA to an intermediate polypeptide. In some embodiments, the intermediate polypeptide is covalently bound to a solid support. In some embodiments, the binding of HMW HA to the intermediate polypeptide is non-covalent. In some embodiments, the intermediate polypeptide is a HA binding protein (HABP). In some embodiments, the intermediate polypeptide is HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, brevican, phosphacan, TSG-6, CD44, stabilin-1, stabilin-2, or HABP selected from some of these sufficient to bind to HA. In some embodiments, the intermediate polypeptide is versican. In some embodiments, the intermediate polypeptide includes a link module. In some embodiments, the intermediate polypeptide comprises a HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1 or stabilin-2 link module. . In some embodiments, the intermediate polypeptide comprises a versican link module. In some embodiments, the intermediate polypeptide comprises a polypeptide as specified in any of SEQ ID NOS: 54-99. In some embodiments, the intermediate polypeptide includes a polypeptide linker. In some embodiments, the linker is attached to a solid support. In some embodiments, the method further comprises dissociating the rcHC-HA / PTX3 complex from the intermediate polypeptide after step (b). In some embodiments, dissociation of the rcHC-HA / PTX3 complex from the intermediate polypeptide includes contacting the complex with a dissociator. In some embodiments, the dissociator is guanidine hydrochloride or urea. In some embodiments, the dissociator is about 4M to about 8M guanidine hydrochloride. In some embodiments, the intermediate polypeptide or linker comprises a protein cleavage sequence. In some embodiments, dissociation of the rcHC-HA / PTX3 complex comprises cleaving the intermediate polypeptide or linker with a protein cleavage sequence. In some embodiments, the cleavage comprises contacting the protein cleavage sequence with a protease. In some embodiments, the protease is selected from among furin, 3C protease, caspase, matrix metalloprotease, and TEV protease.

  In certain embodiments, a method for purifying reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) is described herein, the method comprising: PTX3 / immobilized on a solid support. Contacting the HA complex with an inter-alpha inhibitor (IαI) protein comprising heavy chain 1 (HC1) and TSG-6. In some embodiments, the PTX3 / HA complex is converted to a high molecular weight hyaluronan (HMW HA) to a Pentraxin 3 (PTX3) protein under conditions effective to form a complex of PTX3 and HMW HA (PTX3 / HA). ) And the HMW HA is fixed to a solid support. In some embodiments, the method further comprises removing unbound PTX3 protein prior to contacting the PTX3 / HA complex with IαI and TSG-6. In some embodiments, the method further comprises removing unbound TSG-6. In some embodiments, the PTX3 protein is a recombinant protein. In some embodiments, the PTX3 protein comprises at least 75% 80% of the polypeptide having the sequence specified by SEQ ID NO: 33, or the polypeptide having the sequence specified by SEQ ID NO: 33. Polypeptides having%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity are included. In some embodiments, the PTX3 protein used in the method is a multimeric protein. In some embodiments, the PTX3 protein used in the method is a homomultimer. In some embodiments, the PTX3 homomultimer is a dimer, trimer, tetramer, pentamer, hexamer, octamer. In some embodiments, the PTX3 homomultimer is an octamer. In some embodiments, PTX3 comprises a modified multimerization domain or a heterogeneous multimerization domain. In some embodiments, TSG-6 is a recombinant protein. In some embodiments, TSG-6 is at least 75% of a polypeptide having a sequence specified by SEQ ID NO: 2, or a polypeptide having a sequence specified by SEQ ID NO: 2. Polypeptides having 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity are included. In some embodiments, HC1 is at least 75%, 80% relative to a polypeptide having the sequence specified by SEQ ID NO: 47 or a polypeptide having the sequence specified by SEQ ID NO: 47. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. In some embodiments, the IαI protein also includes HC2. In some embodiments, the HC2 has a polypeptide having a sequence specified by SEQ ID NO: 49, or at least 75%, 80% to a polypeptide having the sequence specified by SEQ ID NO: 49. Polypeptides having%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity are included. In some embodiments, the IαI protein also includes bikunin. In some embodiments, bikunin is at least 75%, 80% relative to a polypeptide having a sequence specified as SEQ ID NO: 53, or a polypeptide having a sequence specified as SEQ ID NO: 53. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. In some embodiments, IαI also includes a chondroitin sulfate chain. In some embodiments, the IαI protein is a recombinant protein. In some embodiments, the IαI protein is isolated from blood, plasma, serum, amniotic membrane, chorion, amniotic fluid, or a combination thereof. In some embodiments, the IαI protein is isolated from serum. In some embodiments, the IαI protein is isolated from human serum. In some embodiments, the IαI and TSG-6 proteins are 1: 1, 2: 1, 3: 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, 9: Contact at a molar ratio of 1, 10: 1, 15: 1, or 20: 1. In some embodiments, the IαI and TSG-6 proteins are contacted at a 3: 1 molar ratio. In some embodiments, the weight average molecular weight of the HMW HA is between about 500 kDa and about 10,000 kDa, between about 800 kDa and about 8,500 kDa, between about 1100 kDa and about 5,000 kDa, or about 1400 kDa. It is between about 3,500 kDa. In some embodiments, the weight average molecular weight of HMW HA is 3,000 kDa. In some embodiments, the HMW HA is immobilized by direct bonding to a solid support. In some embodiments, the HMW HA is immobilized by indirect bonding to a solid support. In some embodiments, the HMW HA is covalently immobilized to a solid support. In some embodiments, the HMW HA is immobilized non-covalently to a solid support. In some embodiments, the method further comprises dissociating the rcHC-HA / PTX3 complex from the solid support. In some embodiments, the method further comprises purifying the dissociated rcHC-HA / PTX3 complex. In some embodiments, purification includes affinity purification, centrifugation, filtration, chromatography, or a combination thereof. In some embodiments, the PTX3, IαI HC1, or TSG-6 polypeptide comprises an affinity tag. In some embodiments, the affinity tag is selected from a hemagglutinin tag, a poly-histidine tag, a myc tag, a FLAG tag, a glutathione-S-transferase (GST) tag. In some embodiments, the HMW HA is immobilized by binding the HMW HA to an intermediate polypeptide. In some embodiments, the intermediate polypeptide is covalently bound to a solid support. In some embodiments, the binding of HMW HA to the intermediate polypeptide is non-covalent. In some embodiments, the intermediate polypeptide is a HA binding protein (HABP). In some embodiments, the intermediate polypeptide binds to HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1, stabilin-2, or HA. HABP selected from some of these sufficient to do. In some embodiments, the intermediate polypeptide is versican. In some embodiments, the intermediate polypeptide further comprises a link module. In some embodiments, the intermediate polypeptide comprises a HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1 or stabilin-2 link module. . In some embodiments, the intermediate polypeptide comprises a versican link module. In some embodiments, the intermediate polypeptide comprises a polypeptide specified in any of SEQ ID NOS: 54-99. In some embodiments, the intermediate polypeptide includes a polypeptide linker. In some embodiments, the linker is attached to a solid support. In some embodiments, the method comprises dissociating the rcHC-HA / PTX3 complex from the intermediate polypeptide. In some embodiments, dissociation of the rcHC-HA / PTX3 complex from the intermediate polypeptide comprises contacting the complex with a dissociator. In some embodiments, the dissociator is guanidine hydrochloride or urea. In some embodiments, the dissociator is about 4M to about 8M guanidine hydrochloride. In some embodiments, the intermediate polypeptide or linker comprises a protein cleavage sequence. In some embodiments, dissociating includes cleaving the intermediate polypeptide or linker with a protein cleavage sequence. In some embodiments, the cleavage comprises contacting the protein cleavage sequence with a protease. In some embodiments, the protease is selected from among furin, 3C protease, caspase, matrix metalloprotease, and TEV protease.

  In certain embodiments, a reconstituted HC-HA (rcHC-HA / PTX3) complex produced by any of the methods provided herein to produce a rcHC-HA / PTX3 complex. Are described herein.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex promotes macrophage M2 polarization. In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex promotes M2 polarization of macrophages. In certain embodiments, a method for inducing macrophage M2 polarization is described herein, wherein the method contacts macrophages with a rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex. Process.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex decreases the expression of IL-12p40 in macrophages stimulated with LPS, and the value of IL-12p40 expressed by macrophages stimulated with LPS is in the absence of the rcHC-HA / PTX3 complex. Compared to the value of IL-12p40 expressed by macrophages stimulated with LPS at rcHC-HA / PTX3 complexes were even lower when contacted with macrophages stimulated with LPS. In some embodiments, the value of IL-12p40 mRNA is decreased. In some embodiments, the value of IL-12p40 protein is decreased.

  In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex reduced the expression of IL-12p40 in macrophages stimulated with LPS, and the value of IL-12p40 expressed by macrophages stimulated with LPS was reduced in LPS in the absence of nHC-HA / PTX3 complex. Compared to IL-12p40 values expressed by stimulated macrophages, it is lower when in contact with the nHC-HA / PTX3 complex. In some embodiments, the value of IL-12p40 mRNA is decreased. In some embodiments, the value of IL-12p40 protein is decreased.

In certain embodiments, provided herein are methods for reducing the level of IL-12p40 expressed by LPS-stimulated macrophages, comprising: rcHC-HA / PTX3, or isolated nHC- Contacting the HA / PTX3 complex with macrophages stimulated with LPS.
In some embodiments, the value of IL-12p40 mRNA is decreased. In some embodiments, the value of IL-12p40 protein is decreased.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3 and IαI HC1 is described herein and rcHC-HA / PTX3 complex decreases the expression of IL-12p70 protein in macrophages stimulated with LPS, and the amount of IL-12p70 protein expressed by macrophages stimulated with LPS is not increased in the rcHC-HA / PTX3 complex. In comparison, the amount of LPS-stimulated macrophages is less in contact with the rcHC-HA / PTX3 complex compared to the amount of IL-12p70 protein expressed by LPS-stimulated macrophages.

  In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex reduces the expression of IL-12p70 protein in macrophages stimulated with LPS, and the amount of IL-12p70 protein expressed by macrophages stimulated with LPS is in the absence of the nHC-HA / PTX3 complex. Thus, when compared to the amount of IL-12p70 protein expressed by macrophages stimulated with LPS, there are fewer when macrophages stimulated with LPS contact the nHC-HA / PTX3 complex.

  In certain embodiments, a method for reducing the level of IL-12p70 protein expressed by LPS-stimulated macrophages is described herein, comprising: rcHC-HA / PTX3 or isolated nHC-HA / Contacting the PTX3 complex with LPS-stimulated macrophages.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex decreases the expression of IL-23 in macrophages stimulated with LPS, and the value of IL-23 expressed by macrophages stimulated with LPS is different from that of the rcHC-HA / PTX3 complex. In comparison, when compared to IL-23 values expressed by LPS-stimulated macrophages, LPS-stimulated macrophages are less in contact with the rcHC-HA / PTX3 complex. In some embodiments, the level of IL-23 mRNA is decreased. In some embodiments, the value of IL-23 protein is decreased.

  In certain embodiments, a natural HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein, wherein the complex is an LPS Decreased the expression of IL-23 in macrophages stimulated with ILS, and the value of IL-23 expressed by macrophages stimulated with LPS was stimulated with LPS in the absence of nHC-HA / PTX3 complex Compared to the value of IL-23 expressed by macrophages, it is lower when LPS-stimulated macrophages contact the nHC-HA / PTX3 complex. In some embodiments, the value of IL-23 mRNA is decreased. In some embodiments, the value of IL-23 protein is decreased.

  In certain embodiments, a method for reducing the level of IL-23 expressed by LPS-stimulated macrophages is described herein, comprising: rcHC-HA / PTX3 or isolated nHC-HA / PTX3 Contacting the complex with macrophages stimulated with LPS. In some embodiments, the level of IL-23 mRNA is decreased. In some embodiments, the value of IL-23 protein is decreased.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex increases the expression of IL-10 in macrophages stimulated with LPS, and the value of IL-10 expressed by macrophages stimulated with LPS depends on the absence of rcHC-HA / PTX3 complex. In comparison, when compared to IL-10 values expressed by LPS-stimulated macrophages, LPS-stimulated macrophages are more in contact with the rcHC-HA / PTX3 complex. In some embodiments, the value of IL-10 mRNA is increased. In some embodiments, the value of IL-10 protein is increased.

  In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein, wherein the complex is an LPS Increases the expression of IL-10 in macrophages stimulated with / IFNγ, and the amount of IL-10 expressed by macrophages stimulated with LPS / IFNγ is low in the absence of nHC-HA / PTX3 complex. Compared to the amount of IL-10 expressed by macrophages stimulated with / IFNγ, macrophages stimulated with LPS are higher when they contact the nHC-HA / PTX3 complex. In some embodiments, the value of IL-10 mRNA is increased. In some embodiments, the value of IL-10 protein is increased.

  In certain embodiments, a method for increasing the level of IL-10 expressed by LPS-stimulated macrophages is described herein, comprising: rcHC-HA / PTX3 or isolated nHC-HA / Contacting the PTX3 complex with LPS-stimulated macrophages. In some embodiments, the value of IL-10 mRNA is increased. In some embodiments, the value of IL-10 protein is increased.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex promotes apoptosis of neutrophils stimulated with LPS, but does not promote apoptosis in resting neutrophils. In some embodiments, the reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is LPS-stimulated neutrophil The number of neutrophils stimulated with apoptotic LPS and stimulated with LPS-stimulated neutrophils in the sample of LPS stimulated apoptosis in the sample in the absence of the rcHC-HA / PTX3 complex. Compared to the number of neutrophils stimulated with sex LPS, the sample is more likely to contact the rcHC-HA / PTX3 complex.

  In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex promotes apoptosis of neutrophils stimulated with LPS, but does not promote apoptosis in resting neutrophils. In some embodiments, nHC-HA / PTX3 complexes comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 promoted LPS-stimulated neutrophil apoptosis and were stimulated with LPS. The number of apoptotic LPS-stimulated neutrophils in the neutrophil sample is the number of apoptotic, LPS-stimulated neutrophils in the sample in the absence of the nHC-HA / PTX3 complex. Compared to the number, the sample is more likely to contact the nHC-HA / PTX3 complex.

  In certain embodiments, a method for causing apoptosis of neutrophils stimulated with LPS is described herein, the method comprising activating rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex to LPS. Contacting the neutrophils stimulated with.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex promotes phagocytosis of apoptotic neutrophils and is apoptotic by phagocytosis by LPS-stimulated and LPS-stimulated macrophages in samples of apoptotic neutrophils The number of neutrophils is greater in the rcHC-HA / PTX3 complex compared to the number of neutrophils phagocytosed by LPS-stimulated macrophages in the sample in the absence of the rcHC-HA / PTX3 complex. There are more people in contact. In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and the complex Promotes phagocytosis of apoptotic neutrophils, and the number of apoptotic neutrophils phagocytosed by resting and resting macrophages in a sample of apoptotic neutrophils is rcHC-HA / Compared to the number of neutrophils phagocytosed by resting macrophages in the sample in the absence of PTX3 complex, the sample is more likely to contact the rcHC-HA / PTX3 complex.

  In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex promotes phagocytosis of apoptotic neutrophils and is phagocytosed by LPS-stimulated and LPS-stimulated macrophages in a sample of apoptotic neutrophils Is the number of neutrophils phagocytosed by LPS-stimulated macrophages in the sample in the absence of nHC-HA / PTX3 complex when the sample contacts the nHC-HA / PTX3 complex. There are more. In certain embodiments, a natural HC-HA / PTX3 (nHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and nHC-HA / PTX3 The complex promotes phagocytosis of apoptotic neutrophils, and the number of apoptotic neutrophils phagocytosed by resting macrophages and LPS-stimulated macrophages in apoptotic neutrophil samples In the absence of the nHC-HA / PTX3 complex, the sample is more likely to contact the nHC-HA / PTX3 complex compared to the number of neutrophils phagocytosed by resting macrophages in the sample.

  In certain embodiments, a method for causing phagocytosis of apoptotic neutrophils is described herein, wherein the method involves apoptotic rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex. Contacting a sample comprising neutrophils with LPS-stimulated or resting macrophages.

  In certain embodiments, a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex comprising high molecular weight hyaluronan (HMW HA), PTX3, and IαI HC1 is described herein and rcHC— The HA / PTX3 complex can be human umbilical cord, native HC-HA / PTX3 isolated from human amniotic membrane (nHC-HA / PTX3), or nHC-HA / from both human umbilical cord and human amniotic membrane. Promotes the binding of LPS-stimulated macrophages to reach at least the same level as the PTX3 complex combination, the binding of rcHC-HA / PTX3 or nHC-HA / PTX3 complex immobilized on a solid support Including contacting the body with LPS-stimulated macrophages. In some embodiments, nHC-HA / PTX3 is isolated from human umbilical cord. In some embodiments, nHC-HA / PTX3 is isolated from human amniotic membrane. In some embodiments, nHC-HA / PTX3 is isolated from a combination of nHC-HA / PTX3 complexes from both human umbilical cord and human amniotic membrane.

  In some embodiments, the nMW-HA / PTX3 or rcHC-HA / PTX3 complex has an HMW HA weight average molecular weight of between about 500 kDa and about 10,000 kDa, between about 800 kDa and about 8,500 kDa, Between about 1100 kDa and about 5,000 kDa, or between about 1400 kDa and about 3,500 kDa. In some embodiments, the nMW-HA / PTX3 or rcHC-HA / PTX3 complex has a weight average molecular weight of HMW HA of about 3,000 kDa.

  In some embodiments, HC1 of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is covalently bound to HA.

  In some embodiments, the PTX3 protein of the rcHC-HA / PTX3 complex is a recombinant protein. In some embodiments, the PTX3 of the rcHC-HA / PTX3 complex is a polypeptide having a sequence specified by SEQ ID NO: 33, or a polypeptide having a sequence specified by SEQ ID NO: 33. Polypeptides having at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity to. In some embodiments, the PTX3 protein used in the method is a multimeric protein. In some embodiments, the PTX3 protein used in the method is a homomultimer. In some embodiments, the PTX3 homomultimer is a dimer, trimer, tetramer, pentamer, hexamer, or octamer. In some embodiments, the PTX3 homomultimer is a trimer, tetramer, or octamer. In some embodiments, the PTX3 homomultimer is an octamer.

  In some embodiments, the IαI HCl of the rcHC-HA / PTX3 complex is a polypeptide having a sequence specified by SEQ ID NO: 47, or a polypeptide having a sequence specified by SEQ ID NO: 47 A polypeptide having at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity to. In some embodiments, IαI HCl of the rcHC-HA / PTX3 complex is a recombinant protein.

  In some embodiments, the rcHC-HA / PTX3 complex comprises TSG-6. In some embodiments, the TSG-6 protein is a recombinant protein. In some embodiments, the TSG-6 protein is at least 75% relative to a polypeptide having a sequence specified by SEQ ID NO: 2, or a polypeptide having a sequence specified by SEQ ID NO: 2. , 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% polypeptide having amino acid sequence identity.

  In some embodiments, the PTX3, IαI HC1, or TSG-6 polypeptide of the rcHC-HA / PTX3 complex comprises an affinity tag. In some embodiments, the affinity tag is selected from a hemagglutinin tag, a poly-histidine tag, a myc tag, a FLAG tag, a glutathione-S-transferase (GST) tag.

  In certain embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by a method provided herein is provided herein. It is described in the book. In some embodiments, the pharmaceutical composition further comprises a pharmaceutically acceptable carrier or excipient. In some embodiments, the pharmaceutical composition is in the form of a solution, suspension, powder, ointment, tablet, capsule, or aerosol. In some embodiments, the pharmaceutical composition is in the form of a solid, a cross-linked gel, or a liposome. In some embodiments, the pharmaceutical composition is in the form of a crosslinked hyaluronan hydrogel. In some embodiments, the pharmaceutical composition comprises a natural polymer. In some embodiments, the natural polymer comprises fibronectin, collagen, laminin, keratin, fibrin, fibrinogen, hyaluronic acid, heparan sulfate, chondroitin sulfate, or combinations thereof. In some embodiments, the pharmaceutical composition further comprises an anti-inflammatory agent, an anti-scarring agent, an anti-tumor agent, a chemotherapeutic agent, an immunosuppressive agent, a cytotoxic agent, an antibacterial agent, or a combination thereof. Including.

  In certain embodiments, of an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by a method provided herein for the manufacture of a drug Use is described herein.

  In certain embodiments, combinations including the following are described herein: (a) nHC-HA / as described herein or generated by the methods provided herein. A PTX3 or rcHC-HA / PTX3 complex; and (b) an anti-inflammatory, anti-scar, anti-tumor, chemotherapeutic, immunosuppressive, cytotoxic, antimicrobial, or combination thereof.

  In certain embodiments, administering a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 as described herein or produced by a method provided herein A method of treatment comprising the steps of:

  In certain embodiments, a method for preventing or reversing scar formation or fibrosis in tissue is described herein, and the method is described or provided herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced by the method to a subject in need. In some embodiments, the method comprises contacting the tissue with an effective amount of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the scar is a scar from dermatitis, keloid scar, spastic scar, hypertrophic scar, acne. In certain embodiments, an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described or produced by a method provided herein to reduce or prevent scarring. The use of is described herein. In some embodiments, administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by the methods provided herein is intra-tissue. Reduce or prevent scarring or fibrosis by reducing or inhibiting TGF-β signaling in

  In certain embodiments, a method for preventing or reducing inflammation in a subject is described herein, and the method is described herein or produced by a method provided herein. Administering to the subject an effective amount of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the method comprises contacting the inflamed tissue with an nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the inflammation is acute or chronic inflammation. In some embodiments, the subject has an inflammatory disease. In some embodiments, the inflammatory disease is a macrophage-mediated inflammatory disease, a Th-17-mediated immune disorder, or a T cell-mediated inflammatory disease. In some embodiments, the subject has an autoimmune disease, allergy, leukocyte deficiency, infection, graft-versus-host disease, tissue transplant rejection, or a combination thereof. In some embodiments, the inflammatory disease is rheumatoid arthritis. In some embodiments, the inflammatory disease is an inflammatory disease of the eye. In some embodiments, the inflammatory disease is conjunctivitis, keratitis, blepharitis, blepharoconjunctivitis, scleritis, epiduralitis, uveitis, retinitis, or choroiditis. In some embodiments, the acute inflammation is caused by myocardial infarction, stroke, endotoxin shock, or sepsis. In some embodiments, the subject suffers from atherosclerosis. In some embodiments, the subject has cancer. In some embodiments, the subject has solid tumor inflammation. In some embodiments, the subject is administered an nHC-HA / PTX3 or rcHC-HA / PTX3 complex in combination with an additional anti-inflammatory agent. In some embodiments, the additional anti-inflammatory agent is an anti-TGF-β antibody, an anti-TGF-β receptor blocking antibody, an anti-TNF antibody, an anti-TNF receptor blocking antibody, an anti-IL1β antibody, an anti-IL1β receptor blocking antibody. An anti-IL2 antibody, an anti-IL2 receptor blocking antibody, an anti-IL6 antibody, an anti-IL6 receptor blocking antibody, an anti-IL12 antibody, an anti-IL12 receptor blocking antibody, an anti-IL17 antibody, an anti-IL17 receptor blocking antibody, an anti-IL23 antibody, or , Selected from anti-IL23 receptor blocking antibodies. In some embodiments, the type 1 interferon is IFN-α or IFN-β. In certain embodiments, an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by a method provided herein to reduce or prevent inflammation The use of the body is described herein.

  In certain embodiments, a method of treating a subject's skin wound or ulcer is described herein, and the method is described herein or produced by a method provided herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the subject. In some embodiments, the method comprises contacting the skin wound or ulcer with an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In certain embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 as described herein or generated by the methods provided herein for treating skin wounds or ulcers. The use of the complex is described herein. In some embodiments, the skin wound or ulcer is a non-healing ulcer.

  In certain embodiments, a method for promoting or causing bone formation in a subject is described herein, the method being described herein or generated by a method provided herein. Administering an effective amount of rcHC-HA / PTX3 complex or nHC-HA / PTX3 complex to the subject. In some embodiments, the subject suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In certain embodiments, nHC-HA / PTX3 or rcHC- described herein or generated by a method provided herein to promote or cause bone formation in a subject. The use of the HA / PTX3 complex is described herein.

  In certain embodiments, a method for preventing or reducing abnormal angiogenesis in a subject is described herein, the method being described herein or provided by a method provided herein. Administering to the subject an effective amount of the produced nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the subject suffers from wet age-related macular degeneration (wARMD) or diabetic proliferative retinopathy. In some embodiments, the subject has cancer. In some embodiments, the subject has a solid tumor. In some embodiments, the subject is administered an nHC-HA / PTX3 or rcHC-HA / PTX3 complex in combination with an anti-cancer treatment. In some embodiments, the anti-cancer therapy includes administration of an anti-tumor agent, cytotoxic agent, anti-angiogenic agent, chemotherapeutic agent, or radiation therapy. In some embodiments, the anti-cancer therapy is administered continuously, simultaneously, or intermittently with the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In certain embodiments, to reduce or prevent angiogenesis, nHC-HA / PTX3 or rcHC-HA / PTX3 of an HCHC-HA / PTX3 described herein or produced by a method provided herein. The use of the complex is described herein.

  In certain embodiments, a method for preventing transplant rejection within a transplant recipient is described herein, and the method is produced by a method described herein or provided herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the transplant recipient. In some embodiments, the method comprises contacting the graft with a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered before the transplant procedure, after the transplant procedure, or during the transplant procedure. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered in combination with an immunosuppressive agent. In certain embodiments, nHC-HA / PTX3 or rcHC-, as described herein or generated by a method provided herein, to prevent transplant rejection within a transplant recipient. The use of the HA / PTX3 complex is described herein. In some embodiments, the graft is a corneal graft.

  In certain embodiments, a method for causing expansion of a subject's stem cells is described herein, the method being described herein or generated by a method provided herein, Administering to the subject an effective amount of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the method comprises contacting stem cells with an nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In certain embodiments, an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by a method provided herein to cause stem cell expansion. The use of is described herein. In some embodiments, administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by the methods provided herein comprises TGF- Inhibition of β signaling and / or upregulation of the BMP signaling pathway causes stem cell expansion. In some embodiments, administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by the methods provided herein is a differentiated cell. Is reprogrammed into stem cells (or induced progenitor cells, iPSCs) to cause expansion of the stem cells.

  In certain embodiments, of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex, as described herein, or produced by the methods provided herein for cell therapy. Use is described herein.

  In certain embodiments, a method of cell therapy for a subject is described herein, the method being an effective, as described herein, or generated by a method provided herein. Administering a composition comprising an amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex in combination with therapeutic cells to a subject. In some embodiments, the therapeutic cells and the nHC-HA / PTX3 or rcHC-HA / PTX3 complex are administered locally to the damaged tissue. In some embodiments, the therapeutic cells and the nHC-HA / PTX3 or rcHC-HA / PTX3 complex are administered systemically. In some embodiments, the therapeutic cell is a stem cell. In some embodiments, the therapeutic cell is a stem cell. In some embodiments, the cell therapy comprises administration of stem cells. In some embodiments, the stem cell is a mesenchymal stem cell. In some embodiments, the stem cell is an induced precursor stem cell. In some embodiments, cell therapy includes administration of differentiated cells. In some embodiments, the therapeutic cell is an insulin producing cell. In some embodiments, the insulin producing cells are islet cells. In some embodiments, the subject has type 1 diabetes.

  In certain embodiments, a method of cell therapy for a subject is described herein, the method being an effective, as described herein, or generated by a method provided herein. Administering an amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to a subject in combination with cells encased in a cell delivery device. In some embodiments, the cells are encapsulated in microcapsules. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to a microcapsule. In some embodiments, the microcapsules are administered locally to the damaged tissue. In some embodiments, the therapeutic cells and the nHC-HA / PTX3 or rcHC-HA / PTX3 complex are administered systemically. In some embodiments, the therapeutic cell is a stem cell. In some embodiments, the therapeutic cell is a stem cell. In some embodiments, the cell therapy comprises administration of stem cells. In some embodiments, the stem cell is a mesenchymal stem cell. In some embodiments, the stem cell is an induced precursor stem cell. In some embodiments, the cell therapy comprises administration of differentiated cells. In some embodiments, the therapeutic cell is an insulin producing cell. In some embodiments, the insulin producing cells are islet cells. In some embodiments, the subject has type 1 diabetes.

  In certain embodiments, a method for preventing or reducing injury to a subject is described herein, the method described herein or generated by a method provided herein, Administering an effective amount of an nHC-HA / PTX3 or rcHC-HA / PTX3 complex to a subject, wherein the pain is a chemical burn, severe bacterial keratitis, Stevens-Johnson syndrome, moderate Toxic epidermal necrosis, caused by eye tumor radiation. In certain embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 as described herein or generated by the methods provided herein for reducing pain in a subject. The use of the complex is described herein and pain is caused by chemical burns, severe bacterial keratitis, Stevens-Johnson syndrome, toxic epidermal necrosis, eye tumor radiation .

  In certain embodiments, a method for causing or promoting tissue regeneration in a subject is described herein, and the method is described herein or generated by a method provided herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the subject. In some embodiments, the method comprises contacting the subject's damaged tissue with an effective amount of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the tissue is bone or gum, corneal tissue, or conjunctival tissue. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered in combination with a therapeutic cell, a plurality of therapeutic cells, or a tissue graft. In some embodiments, the tissue graft is an allograft or an autograft. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered in conjunction with a tissue-based therapy. In certain embodiments, nHC-HA / PTX3 or rcHC- described herein or generated by a method provided herein to cause or promote tissue regeneration in a subject. The use of the HA / PTX3 complex is described herein.

  In certain embodiments, a method for treating fibrosis in a subject is described herein, the method being described herein or generated by a method provided herein, Administering to the subject an effective amount of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the treatment inhibits or prevents scarring. In certain embodiments, nHC-HA / PTX3 or rcHC-HA /, as described herein or generated by a method provided herein, for treating fibrosis in a subject. The use of PTX3 complexes is described herein.

  In certain embodiments, a method for treating obesity or insulin resistance in a subject is described herein, and the method is produced by a method described or provided herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the subject. In some embodiments, the treatment suppresses or reduces the amount of M1 adipose tissue macrophage in the subject. In certain embodiments, a method for suppressing or reducing the amount of M1 adipose tissue macrophage in a subject is described herein, and the method is described herein or provided herein. Administering to the subject an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced by the method. In some embodiments, the subject has been diagnosed with obesity or insulin resistance. In certain embodiments, nHC-HA / PTX3 or rcHC described herein or generated by a method provided herein to treat obesity or insulin resistance in a subject. The use of the HA / PTX3 complex is described herein.

  In certain embodiments, a method for treating conjunctival laxity in a subject is described herein, the method being described or generated by a method described herein. Administering an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the subject. In some embodiments, the method comprises contacting an effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex with the subject's conjunctiva. In certain embodiments, nHC-HA / PTX3 or rcHC-HA as described herein or generated by a method provided herein for treating conjunctival laxity in a subject. The use of the / PTX3 complex is described herein.

  In certain embodiments, suitable for culturing cells with the rcHA / PTX3 complex or nHC-HA / PTX3 complex described herein or produced by the methods provided herein. Cell culture media containing various substrates are described herein. In some embodiments, the rcHA / PTX3 complex or nHC-HA / PTX3 complex is immobilized on a substrate.

  In certain embodiments, a therapy is described herein, and the subject is generated by a method described herein or provided herein in combination with an additional therapeutic agent. An effective amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered. In some embodiments, the additional therapeutic agent is an interferon, an anti-tumor necrosis agent, an interleukin 1 (IL-1) receptor antagonist, an interleukin 2 (IL-2) receptor antagonist, interleukin 6 (IL- 6) receptor antagonist, interleukin-12 (IL-12) receptor antagonist, interleukin-17 (IL-17) receptor antagonist, interleukin-23 (IL-23) receptor antagonist, cytotoxic agent, antibacterial agent , Interleukins, immunomodulators, antibiotics, T cell costimulatory blockers, disorder-modifying anti-rheumatic agents, immunosuppressants, anti-lymphocyte antibodies, anti-angiogenic agents, chemotherapeutic agents, anti-neoplastic agents, anti-metabolism Product, Akt inhibitor, IGF-1 inhibitor, angiotensin II receptor antagonist, siku Oxygenase inhibitor, heparanase inhibitor, lymphokine inhibitor, cytokine inhibitor, IKK inhibitor, P38 MAPK inhibitor, anti-apoptotic pathway inhibitor, apoptotic pathway agonist, PPAR agonist, RAS inhibitor, telomerase inhibitor, protease inhibitor, It is selected from metalloprotease inhibitors, aminopeptidase inhibitors, SHIP activators, and combinations thereof. In some embodiments, the antimicrobial agent is an antiviral agent, an antimicrobial agent, or an antifungal agent.

  In certain embodiments, a treatment method is described herein, and the subject has an effective amount of nHC-HA as described herein or produced by a method provided herein. / PTX3 or rcHC-HA / PTX3 complex is administered and the subject is a mammal. In some embodiments, the mammal is a human.

  In certain embodiments, therapies are described herein and the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is applied to a solid surface. In some embodiments, the solid surface is a surface of a nanoparticle, bead, microcapsule, or implantable medical device or part thereof.

  In certain embodiments, a medical device comprising a substrate coated with a complex of nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the substrate is a stent, joint, screw, rod, pin, plate, clasp, shunt, forceps, clip, suture, suture anchor, electrode, catheter, lead, graft, dressing Pacemaker, pacemaker housing, cardioverter defibrillator, cardioverter defibrillator housing, defibrillator, defibrillator housing, orthosis, ear drainage tube, ocular implant, orthopedic surgery Device, intervertebral disc, bone substitute, anastomosis device, perivascular wrap, a colostomy bag attachment device, hemostatic barrier, vascular graft, vascular support, tissue adhesive A tissue sealant, a tissue scaffold, and an intraluminal device.

  In certain embodiments, an apparatus comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein or produced by a method provided herein is provided herein. It is described in the book. In some embodiments, the surface is a polystyrene, polyethylene, silica, metal or polymer surface. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to a microcapsule. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to the nanoparticles. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to a bead, chip, glass slide, or filter. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to a contact lens. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is attached to a surgical graft or brace. In some embodiments, the graft or brace is an artificial joint, bone implant, suture, or stent. In some embodiments, the artificial joint is a hip prosthesis, an artificial knee, an artificial shoulder joint, or an artificial knee. In some embodiments, the stent is a coronary stent, ureteral stent, urethral stent, prostate stent, esophageal stent, or bone stent.

  In certain embodiments, a medical device comprising a structure suitable for implantation in a patient is described herein, and a surface or portion of the surface is described herein, or An nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced by the method provided herein is attached. In some embodiments, the binding comprises covalent or non-covalent binding of a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 to the surface or part of the surface of the structure. In some embodiments, the binding comprises coating a surface of the structure or a portion of the surface with a composition containing a complex of nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the structure is a vascular stent, an artificial joint, a suture, or a microcapsule. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits bacterial biofilm formation. In some embodiments, the microcapsule includes a therapeutic cell. In some embodiments, the therapeutic cell is a stem cell.

  In certain embodiments, a method for modulating macrophage activity is described herein, which reduces or inhibits expression of IL-12 or IL-23, but from the M1 to M2 phenotypes. An amount of nHC-HA / PTX3, as described herein, or produced by a method provided herein, in an amount sufficient to promote expression of IL-10 in polarized macrophages of a step of contacting macrophages with the rcHC-HA / PTX3 complex. In some embodiments, macrophages were stimulated with pro-inflammatory mediators. In some embodiments, the pro-inflammatory mediator is lipopolysaccharide (LPS), tumor necrosis factor α (TNF-α), interferon gamma (IFNγ), or a combination thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex contacts in vivo macrophages in the subject. In some embodiments, the subject is a mammal. In some embodiments, the mammal is a human. In some embodiments, the method is performed ex vivo. In certain embodiments, described herein are methods of treatment that include administration of macrophages modulated by the methods of modulating macrophage activity provided herein.

  In certain embodiments, for administering an nHC-HA / PTX3 or rcHC-HA / PTX3 complex, composition described herein or produced by a method provided herein. Described herein is a kit comprising a device and optionally instructions for administration.

  In certain embodiments, (a) a complex of PTX3 pre-bound to HMW HA (PTX3 / HA), (b) an inter-alpha inhibitor (IαI) protein comprising heavy chain 1 (HC1), and (c) TSG Combinations or mixtures are described herein, including -6.

  In certain embodiments, a combination or mixture comprising (a) a complex of TSG-6 pre-bound to HC-HA and (b) PTX3 is described herein.

  In certain embodiments, a method for generating a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex in vitro is described herein, the method comprising (a) TSG-6. In order to form a pre-bound rcHC-HA complex, (i) a high molecular weight hyaluronan (HMW HA) immobilized on a solid support, (ii) an inter alpha inhibitor (IαI) comprising heavy chain 1 (HC1) (Iii) contacting TSG-6 with the protein, and (b) rcHC-HA complex previously bound to TSG-6 to form rcHC-HA / PTX3 complex, pentraxin 3 ( PTX3) comprising contacting with protein.

  In certain embodiments, a method for generating reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) in vitro is described herein, the method comprising an immobilized rcHC-HA / PTX3 complex. (I) high molecular weight hyaluronan (HMW HA) immobilized on a solid support, (ii) pentraxin 3 (PTX3) protein, (iii) heavy chain 1 (HC1) inter-alpha inhibitor ( Contacting IαI) protein and (iv) gene 6 (TSG-6) stimulated with tumor necrosis factor α.

  In certain embodiments, complexes comprising immobilized HA bound to PTX3 are described herein.

  In certain embodiments, a method for producing a complex comprising immobilized HA bound to PTX3 in vitro is described herein, wherein the method comprises a complex of PTX3 and HMW HA (PTX3 / HA). The process includes contacting the PTX3 protein with high molecular weight hyaluronan (HMW HA) under conditions effective to form, wherein the HMW HA is immobilized on a solid support. In some embodiments, the PTX3 protein is a native PTX3 protein isolated from cells. In some embodiments, the cell is a mammalian cell. In some embodiments, the cell is a human cell. In some embodiments, the cell is an amniotic cell. In some embodiments, the cells are umbilical cord cells. In some embodiments, the cells are umbilical cord to amniotic cells. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, the PTX3 protein is a recombinant protein. In some embodiments, the PTX3 protein comprises at least 75% 80% of a polypeptide having a sequence specified by SEQ ID NO: 2, or a polypeptide having a sequence specified by SEQ ID NO: 2. Polypeptides having%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity are included. In some embodiments, the PTX3 protein used in the method is a multimeric protein. In some embodiments, the PTX3 protein used in the method is a homomultimer. In some embodiments, the PTX3 homomultimer is a dimer, trimer, tetramer, pentamer, hexamer, octamer. In some embodiments, the PTX3 homomultimer is a trimer, tetramer, or octamer. In some embodiments, the PTX3 homomultimer is an octamer. In some embodiments, PTX3 comprises a modified multimerization domain or a heterologous multimerization domain. In some embodiments, immobilization of HMW HA includes non-covalent binding to a solid support. In some embodiments, immobilization of HMW HA comprises binding of HMW HA to an intermediate polypeptide. In some embodiments, the intermediate polypeptide is covalently bound to a solid support. In some embodiments, the binding of HMW HA to the intermediate polypeptide is non-covalent. In some embodiments, the intermediate polypeptide is a HA binding protein (HABP). In some embodiments, the intermediate polypeptide binds HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1, stabilin-2, or HA. HABP selected from some of these sufficient to do. In some embodiments, the intermediate polypeptide is versican. In some embodiments, the intermediate polypeptide includes a link module. In some embodiments, the intermediate polypeptide comprises a HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1 or stabilin-2 link module. Including. In some embodiments, the intermediate polypeptide comprises a versican link module. In some embodiments, the intermediate polypeptide comprises a polypeptide as specified in any of SEQ ID NOS: 54-99. In certain embodiments, PTX3 / HA complexes produced by the aforementioned methods are described herein. In certain embodiments, a pharmaceutical composition comprising a PTX3 / HA complex produced by the aforementioned method is described herein. In certain embodiments, the use of a PTX3 / HA complex for the manufacture of a drug is described herein. In certain embodiments, described herein are methods of treatment comprising administration of a PTX3 / HA complex for the prevention or inhibition of scars, inflammation, angiogenesis, cancer, diabetes, obesity, or fibrosis. .

  In certain embodiments, a method for inducing or maintaining pluripotency of a cell is described herein, the method comprising a cell comprising an nHC-HA / PTX3 complex or an rcHC-HA / PTX3 complex. Culturing, thereby inducing or maintaining cell pluripotency. In some embodiments, the cell heterologously expresses a protein selected from Sox2, myc, Oct4, and KLF4. In some embodiments, the cells heterologously express one, two, or three proteins selected from Sox2, myc, Oct4, and KLF4. In some embodiments, the nHC-HA / PTX3 complex or rcHC-HA / PTX3 complex is immobilized. In some embodiments, the cell is an adult differentiated cell. In some embodiments, the cell is a fibroblast. In some embodiments, the cell is a human corneal fibroblast. In some embodiments, the cells are embryonic stem cells, adult stem cells, embryonic stem cells, or induced pluripotent stem cells. In some embodiments, the cell is a limbal epithelial progenitor cell, a limbal stromal niche cell, an umbilical cord stem cell, an amniotic stem cell, or an adipose stem cell. In some embodiments, the nHC-HA / PTX3 complex is an amniotic nHC-HA / PTX3 complex. In some embodiments, the nHC-HA / PTX3 is a umbilical cord nHC-HA / PTX3 complex. In some embodiments, the method further comprises purifying the nHC-HA / PTX3 complex by subjecting the amniotic membrane extract to ultracentrifugation. In some embodiments, the method is ultracentrifugated on amniotic membrane extract prepared in PBS buffer to produce nHC-HA / PTX3 extract (ie, soluble nHC-HA / PTX3). To further purify the nHC-HA / PTX3 complex. In some embodiments, the method comprises ultracentrifugation with an amniotic membrane extract prepared in GnHCl buffer to produce an nHC-HA / PTX3 extract (ie, soluble nHC-HA / PTX3). And further comprising purifying the nHC-HA / PTX3 complex. In some embodiments, the method further comprises purifying the nHC-HA / PTX3 complex by performing ultracentrifugation with the umbilical cord extract. In some embodiments, the umbilical cord extract comprises umbilical cord amniotic membrane, umbilical cord stroma, Walton jelly, or any combination thereof. In some embodiments, the method is ultracentrifuged with an umbilical cord extract prepared in PBS buffer to produce an nHC-HA / PTX3 extract (ie, soluble nHC-HA / PTX3). To further purify the nHC-HA / PTX3 complex. In some embodiments, the method is ultracentrifuged with an umbilical cord extract prepared in GnHCl buffer to produce an nHC-HA / PTX3 extract (ie, soluble nHC-HA / PTX3). To further purify the nHC-HA / PTX3 complex. In some embodiments, the method further comprises performing 2, 3, or 4 ultracentrifugation. In some embodiments, the method further comprises performing 4 ultracentrifugations. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises PTX3. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises a small leucine-rich proteoglycan (SLRP). In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises PTX3 and a small leucine-rich proteoglycan (SLRP). In some embodiments, the small leucine-rich proteoglycan is decorin, biglycan, fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, osteoadherin. , Epipican, and osteoglycin. In some embodiments, the small leucine-rich proteoglycan is covalently linked to the glycosaminoglycan. In some embodiments, the glycosaminoglycan is keratan sulfate.

  It should be noted that the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of any subject matter claimed.

Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1A-B) Total protein and HA concentrations in fractions obtained by ultracentrifugation of CsCl / 4M guanidine HCl. Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1A-B) Total protein and HA concentrations in fractions obtained by ultracentrifugation of CsCl / 4M guanidine HCl. Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIG. 1C) HA stained by Stains-all staining in 0.5% agarose gel. Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. (FIGS. 1D-J) HC1 (FIGS. 1D and F), PTX3 (FIGS. 1E and G), HC2 (FIG. 1H), HC3 (FIG. 1I), bikunin (FIG. 1J), TSG-6 (FIG. 1K), or Analysis of proteins present in nHC-HA / PTX3 by Western blot using an antibody against TSP-1 (FIG. 1L). Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. Treatment with NaOH or N = 0.05N NaOH at 25 ° C for 1 hour. Treatment with HAase or H = 2 hours at 60 ° C. with 20 units / ml HAase (FIG. 1F-K). Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. Illustrates purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex from amnion extract (AME) and analysis of protein composition and HA size. Bar graph of relative protein levels determined by dot analysis using antibodies against various antigens including IGFBP1-3, PF4, or TIMP-1 (FIG. 1M). 2 illustrates CD44 and TLR4 receptors mediating the binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3. (FIG. 2A) Cell binding. RAW264.7 cells (100 μl of 2.5 × 10 ⁵ cells / ml) were seeded in fixed HA (2 μg / well) or nHC-HA / PTX3 (2 μg / well) (n = 3) and LPS (1 μg / ml ) Stimulated. After 90 minutes incubation, unbound cells were removed and bound cells were counted by CyQuant assay. The scale bar represents 100 μm. An asterisk (*) indicates a p-value of <0.05 (HA or nHC-HA / PTX3 vs PBS control (ctrl) or nHC-HA / PTX3 vs HA). 2 illustrates CD44 and TLR4 receptors mediating the binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3. (FIG. 2B) Cell viability. RAW264.7 cells stimulated with LPS were cultured for 24 hours with fixed PBS control, HA, or nHC-HA / PTX3 (n = 3). Cell viability was measured by MTT assay. No significant differences (all p values> 0.05) in cell viability of cells on these immobilized substrates were observed. 2 illustrates CD44 and TLR4 receptors mediating the binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3. (FIG. 2C) CD44 and TLR4 receptors are responsible for the binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3. RAW264.7 cells (30% on ice, with isotype control antibody or RGD control peptide plus blocking antibody to CD44, TLR2, TLR4, integrin αv, β1, β2 or β3, or RGD peptide ( 2.5 × 10 ⁵ / ml) was preincubated (n = 3). After adding LPS (1 μg / ml), the cells were incubated for 90 minutes and a cell binding assay was performed in the same manner as described in A. An asterisk (*) indicates a p-value of <0.05. FIG. 4 illustrates the polarization of LPS-stimulated macrophages toward the M2 phenotype by immobilized nHC-HA / PTX3. (A) M1 (TNF-α, IL-12p40) or M2 (IL-10) in macrophages bound to PBS control or immobilized HA or nHC-HA / PTX3 as measured by quantitative PCR. , Arg-1, LIGHT, and SPHK1) relative mRNA expression of markers. (B) Relative TNF-α protein as measured by ELISA. (C) Western blot (left) and cytolocalization (right) by fluorescent immunostaining of IRF5, an M1 marker in macrophages bound to PBS control or immobilized nHC-HA / PTX3. (D) Apoptosis of resting fMLP or LPS stimulated neutrophils after incubation with immobilized nHC-HA / PTX3. An asterisk (*) indicates p <0.05. (E) Apoptotic neutrophil phagocytosis by resting or LPS-stimulated macrophages. An asterisk (*) indicates p <0.05. Illustrates the role of CD44 in maintaining M2 macrophage polarization on immobilized nHC-HA / PTX3. (A) M1 (IL-12p40) after binding to nHC-HA / PTX3 of macrophages preincubated with PBS or blocking antibodies to CD44, TLR4, or CD44 / TLR4 as measured by qPCR. ) And M2 (IL-10, LIGHT, and SPHK1) relative mRNA expression of macrophage markers. An asterisk (*) indicates p <0.05 compared to 0 antibody treatments (no) within the same group. (B) The amount of IL-12 and IL-10 protein as measured by ELISA. An asterisk (*) indicates p <0.05 compared to 0 antibody treatments (no) within the same group. nHC-HA / PTX3 (4th) promotes cell aggregation, while nHC-HA / PTX3 (2nd) and nHC-HA / PTX3 (4th) are both macrophages stimulated with IFN-γ / LPS Production of IL-12p40 and IL-23 proteins, and RAW264.7 cells (2.5 × 10 ⁵ / ml) were cultured on immobilized substrate (PBS as a control) for 4 hours ( A) or 24 hours (B and C) stimulated with IFN-γ / LPS. (A) Cell morphology 4 hours after seeding. Alternatively, cells were stimulated with LPS for 24 hours and IL-10 and IL-12p70 proteins in cell culture supernatants were measured by respective ELISA (B and C). The p value is indicated by B and C. 2 illustrates dose-dependent and covalent binding of HMW HA and nHC-HA / PTX3 to the surface of a 96-well CovaLink ™ plate. (A) HA ELISA of bound HMW HA and nHC-HA / PTX3 after removal of unbound HMW HA and nHC-HA / PTX3. (B) HA ELISA of bound and unbound HA from HMW HA and nHC-HA / PTX3. 2 illustrates the dose-dependent binding of TSG-6 to immobilized HA (iHA) and resistance to various dissociating and reducing agents. (A) TSG-6 bound to iHA as measured by TSG-6 ELISA. (B) TSG-6 bound to iHA as measured by TSG-6 ELISA after treatment with 6M guanidine HCl, 8M guanidine HCl, 2% SDS, 100 mM DTT, or 25 mM NaOH. . 2 illustrates the dose-dependent binding of PTX3 to immobilized HA (iHA) and resistance to various dissociating and reducing agents. (A) PTX3 bound to iHA as measured by PTX3 ELISA. (B) PTX3 bound to iHA as measured by PTX3 ELISA after treatment with 6M guanidine HCl, 8M guanidine HCl, 2% SDS, 100 mM DTT, or 25 mM NaOH. Illustrates the lack of competition or synergy between TSG-6 and PTX3 to bind iHA. Relative absorbance as measured by ELISA is shown for bound TSG-6 or PTX3 for incubation of each factor alone with iHA or combined incubation with iHA. No statistical significance was seen for either TSG-6 or PTX3 binding to iHA, either alone or in combination (P> 0.05). 2 illustrates partial inhibition of PTX3 binding to iHA pre-bound to TSG-6 and lack of inhibition of TSG-6 binding to iHA pre-bound to PTX3. The figure shows the results of TSG-6 and PTX3 ELISA for TSG-6 or PTX3 subsequent binding with respect to prebound TSG-6 / iHA (A), or pre-bound PTX3 / iHA (B). Yes. P values are shown in (A) and no statistical significance was seen in the (B) group. 8 illustrates binding of RAW264.7 macrophages stimulated with LPS to PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. Cells were photographed 24 hours after incubation. Illustrates relative gene expression in RAW264.7 macrophages after incubation on PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. . Total RNA was isolated and IL-12p40 (FIG. 12A) and IL-10 (FIG. 12D) mRNA expression was measured by quantitative PCR. An asterisk (*) indicates p <0.05 compared to the control. Illustrates relative gene expression in RAW264.7 macrophages after incubation on PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. . Alternatively, cells were stimulated with LPS (FIGS. 12B and E) or IFN-γ / LPS (FIG. 12C) for 24 hours, and IL-12p70 (FIG. 12B), IL-23 (FIG. 12C), And the protein expression of IL-10 (FIG. 12E) was measured using each ELISA. An asterisk (*) indicates p <0.05 compared to the control. Illustrates relative gene expression in RAW264.7 macrophages after incubation on PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. . Alternatively, cells were stimulated with LPS (FIGS. 12B and E) or IFN-γ / LPS (FIG. 12C) for 24 hours, and IL-12p70 (FIG. 12B), IL-23 (FIG. 12C), And the protein expression of IL-10 (FIG. 12E) was measured using each ELISA. An asterisk (*) indicates p <0.05 compared to the control. Illustrates relative gene expression in RAW264.7 macrophages after incubation on PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. . Total RNA was isolated and IL-12p40 (FIG. 12A) and IL-10 (FIG. 12D) mRNA expression was measured by quantitative PCR. An asterisk (*) indicates p <0.05 compared to the control. Illustrates relative gene expression in RAW264.7 macrophages after incubation on PBS (control), HA (iHA), nHC-HA / PTX3, TSG-6 / iHA, or PTX3 / iHA. . Alternatively, cells were stimulated with LPS (FIGS. 12B and E) or IFN-γ / LPS (FIG. 12C) for 24 hours, and IL-12p70 (FIG. 12B), IL-23 (FIG. 12C), And the protein expression of IL-10 (FIG. 12E) was measured using each ELISA. An asterisk (*) indicates p <0.05 compared to the control. FIG. 4 illustrates the efficiency of TSG-6 free vs. TSG-6 binding in solution to transfer HC1 and HC2 from IαI to iHA. (FIG. 13A, B) Relatively bound HC1 (FIG. 13A) or IαI (FIG. 13B) after simultaneous or sequential addition of TSG-6 and IαI to iHA as measured by the respective ELISA. . An asterisk (*) indicates p <0.05 at the same TSG-6 concentration when added simultaneously and sequentially. FIG. 4 illustrates the efficiency of binding of free TSG-6 of TSG-6 in solution to transfer HC1 and HC2 from IαI to iHA. (FIG. 13A, B) Relatively bound HC1 (FIG. 13A) or IαI (FIG. 13B) after simultaneous or sequential addition of TSG-6 and IαI to iHA as measured by the respective ELISA. . An asterisk (*) indicates p <0.05 at the same TSG-6 concentration when added simultaneously and sequentially. FIG. 4 illustrates the efficiency of binding of free TSG-6 of TSG-6 in solution to transfer HC1 and HC2 from IαI to iHA. (FIG. 13C) Western blot of samples from A digested with hyaluronidase (HAase) and analyzed with anti-TSG-6 antibody. FIG. 4 illustrates the efficiency of binding of free TSG-6 of TSG-6 in solution to transfer HC1 and HC2 from IαI to iHA. (FIG. 13D) Relative HC1 and PTX3 bound to iHA after co-incubation of PTX3 and IαI with iHA as measured by ELISA. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIGS. 14A-D) Western blot using antibodies against HC1 (FIG. 14A), HC2 (FIG. 14B), TSG-6 (FIG. 14C), or bikunin (FIG. 14D). HAase = treatment with hyaluronidase. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIGS. 14A-D) Western blot using antibodies against HC1 (FIG. 14A), HC2 (FIG. 14B), TSG-6 (FIG. 14C), or bikunin (FIG. 14D). HAase = treatment with hyaluronidase. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIGS. 14A-D) Western blot using antibodies against HC1 (FIG. 14A), HC2 (FIG. 14B), TSG-6 (FIG. 14C), or bikunin (FIG. 14D). HAase = treatment with hyaluronidase. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIGS. 14A-D) Western blot using antibodies against HC1 (FIG. 14A), HC2 (FIG. 14B), TSG-6 (FIG. 14C), or bikunin (FIG. 14D). HAase = treatment with hyaluronidase. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIG. 14E) Illustration of TSG-6 interaction with IαI. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIG. 14F) Practical example of inhibition of HC2 • TSG-6 formation by PTX3. FIG. 6 illustrates complexes formed in solution after co-incubation of IαI and TSG-6 with or without PTX3. (FIG. 14G) Western blot with antibody against IαI. Illustrates complexes formed on iHA after co-incubation of IαI and TSG-6 with or without PTX3. After washing with 8M GnHCl and PBS, bound HC1, TSG-6, and PTX3 were measured in each ELISA (A, D, F). The asterisk (*) indicates p <0.05 compared to PTX3 at 1 μg / ml. The complex was washed again with 8M GnHCl and PBS and the bound components were digested with 1 unit / ml hyaluronidase for 2 hours. Digested samples were analyzed by Western blot using antibodies against HC1 (B), HC2 (C), TSG-6 (E), and PTX3 (G). Illustrates the complex formed on iHA after the sequential addition of IαI containing TSG-6 followed by the addition of PTX3. Bound HC1, TSG-6, and PTX3 were measured by respective ELISA (A, D, F). The complex was washed again with 8M GnHCl and PBS and the bound components were digested with 1 unit / ml hyaluronidase for 2 hours. Digested samples were analyzed by Western blot using antibodies against HC1 (B), HC2 (C), TSG-6 (E), PTX3 (G). Illustrates the complex formed on iHA after the sequential addition of PTX3 followed by the addition of IαI containing TSG-6. Bound HC1, TSG-6, and PTX3 were measured by respective ELISA (A, C, E). The complex was again washed with 8M GnHCl and PBS and the bound components were digested with 1 unit / ml hyaluronidase for 2 hours. Digested samples were analyzed by Western blot using antibodies against PTX3 (B), TSG-6 (D), HC1 (F), and HC2 (G). PBS (control), HA (iHA), nHC-HA / PTX3, (IαI / TSG-6 / PTX3) / iHA (IαI, TSG-6, or PTX3 binds to iHA simultaneously), (IαI / TSG- 6) / PTX3 / iHA (sequential addition of PTX3 over iHA pre-incubated with IαI and TSG-6) or (PTX3) / IαI / TSG-6 / iHA (IαI against iHA pre-incubated with PTX3) Illustrates the binding of RAW264.7 macrophages stimulated with LPS to the sequential addition of TSG-6 and TSG-6. Cells were photographed 24 hours after incubation. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. Total RNA was isolated and IL-10 and IL-12p40 mRNA expression was measured by quantitative PCR (FIGS. 19A and C). An asterisk (*) indicates p <0.05. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. IL-10 and IL-12p70 proteins in the cell culture supernatant were measured by respective ELISA (FIGS. 19B and D). An asterisk (*) indicates p <0.05. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. Total RNA was isolated and IL-10 and IL-12p40 mRNA expression was measured by quantitative PCR (FIGS. 19A and C). An asterisk (*) indicates p <0.05. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. IL-10 and IL-12p70 proteins in the cell culture supernatant were measured by respective ELISA (FIGS. 19B and D). An asterisk (*) indicates p <0.05. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. (FIG. 19E) In cell culture supernatants of resting RAW264.7 cells (no) or as measured by IL-23 ELISA, or IFN-γ (200 units / ml), LPS (1 μg / ml), IL-23 protein in 24 hour stimulated cell culture supernatant of IFN-γ / LPS, LPS containing immune complexes (LPS / IC), or IL-4 (10 ng / ml). An asterisk (*) indicates p <0.05. Illustrates gene expression in RAW 264.7 macrophages cultured on immobilized substrate and stimulated with LPS. (FIG. 19F) Cell culture supernatant of RAW264.7 cells cultured on immobilized substrate and stimulated with IFN-γ / LPS for 24 hours as measured by IL-23 ELISA. IL-23. An asterisk (*) indicates p <0.05. Illustrates immunostaining of HA, PTX3, TSG-6, HC, and bikunin within the human umbilical cord (A) or amniotic membrane (B). Human umbilical cord cryosections with biotinylated HABP with or without HAase digestion and with antibodies to PTX3 and TSG-6, and chain specific antibodies to IαI and PαI components as indicated I investigated. Nuclei were counterstained with Hoechst 33342 (blue). Epi, epithelium. The bar represents 100 μm. Illustrates immunostaining of HA, PTX3, TSG-6, HC, and bikunin within the human umbilical cord (A) or amniotic membrane (B). Human umbilical cord cryosections with biotinylated HABP with or without HAase digestion and with antibodies to PTX3 and TSG-6, and chain specific antibodies to IαI and PαI components as indicated I investigated. Nuclei were counterstained with Hoechst 33342 (blue). Epi, epithelium. The bar represents 100 μm. FIG. 6 illustrates a comparison of PTX3 levels in successive PBS and GnHCl extracts from AM, CH, and UC. A, each lane contains 2 μg HA in lanes 2 and 3 and 20 μg total protein in lanes 4-11. B, each lane contains 40 μg of total protein in lanes 3-10. Illustrates a comparison of HC1, bikunin, and IαI in successive PBS and GnHCl extracts from AM, CH, and UC. Each lane contains 20 μg total protein in A and C, and 40 μg total protein in B and DF, except for the positive control (pos.ctrl). 2 illustrates the comparison of TSG-6 in GnHCl extracts of AM and UC. Each lane contains 40 μg of total protein except for the positive TSG-6 control. Illustrates Western blot analysis of PTX3 (A), HC1 (B), HC2 (C), and TSG-6 (D) in the 1-4th AM HC · HA complex. Each lane contains 4 μg HA, except for the positive control. Illustrates Western blot analysis of TSP-1 in AME, AM GnHCl and 1-4 th HC-HA complex. Each lane of lanes 3, 4, 10, and 11 contains 30 μg of total protein. Each lane of lanes 5-8 and 12-15 contains 4 μg HA. Illustrates Western blot analysis of PTX3 (A), HC1 (B), HC2 (C), HC3 (D), and TSG-6 (E) in the fourth UC HC-HA complex. Each lane contains 4 μg HA, except for the positive control. Illustrates comparison of HC1 (A) and PTX3 (B) in the fourth HC · HA complex from PBS and GnHCl extracts. Each lane contains 4 μg HA, except for the positive control. A comparison of the fourth HC-HA complex from PBS and GnHCl in an agarose gel is illustrated. Each lane contains 15 μg HA, except for the positive HA control. FIG. 4 illustrates Coomassie blue staining for SDS-PAGE gels of GnHCl HC-HA and PBS HC-HA. A. AM PBS and GnHCl HC-HA. B. UC PBS and GnHCl HC-HA. Each lane contains 30 μg HA. It illustrates that keratan sulfate and osteoadherin were present in AM GnHCl HC-HA but not in PBS HC-HA. A. Coomassie blue staining. Each lane contains 30 μg HA. B and C.I. Western blot for keratan sulfate (B) and osteoadherin (C). Each lane contains 4 μg HA. D. Immunostaining for keratin sulfate in AM. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). FIG. 31A. Coomassie blue staining. Each lane contains 30 μg HA, except for lane 6, which contains 5 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Illustrates the deglycosylation and analysis of AM GnHCl HC-HA by SDS-PAGE using CB staining or Western blot (Coomassie Blue). 31B-H. Western blot for osteoadherin (B), decorin (C, D), biglycan (E, F), keratan sulfate (G), and PTX3 (H). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (keratan endo-β-galactosidase sulfate), T: TFMSA (trifluoromethanesulfonic acid). Each lane contains 4 μg HA. Decorin and biglycan illustrate that they are fully present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. FIG. 32A. Coomassie blue staining. Each lane contains 30 μg HA, except for lane 6, which contains 5 μg HA. Decorin and biglycan are well present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Decorin and biglycan are well present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Decorin and biglycan are well present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Decorin and biglycan illustrate that they are fully present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Decorin and biglycan are well present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Decorin and biglycan illustrate that they are fully present in UC GnHCl HC-HA but not in PBS HC-HA. Keratan sulfate, osteoadherin, and bikunin were present in UC GnHCl HC-HA, but not in PBS HC-HA except for keratan sulfate. 32B-G. Western blot for decorin (B), biglycan (C), bikunin (D), PTX3 (E), keratan sulfate (F), and osteoadherin (G). H: hyaluronidase, C: chondroitinase (Cabc), K: keratinase (sultanate endo-β-galactosidase sulfate). Each lane contains 4 μg HA. Illustrates the immunolocalization of PTX3 in human AM. Cryosections of human egg membranes were examined with anti-PTX3, biotinylated HABP with or without HAase digestion, and with chain-specific antibodies to the IαI component. Nuclei were counterstained with Hoechst 33342 (blue). AM, amniotic membrane; Epi, epithelium; CH, chorion. Bar, 100 μm. Illustrates the presence of PTX3 in an AM soluble extract and purified HC-HA complex. Purification before Western blot using anti-PTX3 (A) and anti-HC1 (B) antibodies and analysis on 0.5% agarose gel electrophoresis before staining with Stains-all staining (C) PTX3, AM extract (AME), and AM HC-HA complex with or without 50 mM NaOH for 1 hour at 25 ° C. or with hyaluronidase (HAase) for 1 hour at 37 ° C. Treated with or without. PTX3 species and their multimeric forms were found in AM soluble extracts and purified HC-HA complexes. M, protein ladder marker. Illustrates the expression of PTX3 mRNA and protein by AMEC and AMSC. RNA and protein were extracted from human skin fibroblasts (Skin Fib.) And from both AMEC and AMSC. The expression of PTX3 mRNA (A) and protein in the supernatant and cell lysate (B) was compared. PTX3 siRNA transfection was performed to confirm the expression of PTX3 in AMEC and AMSC (C). Illustrates the morphological changes of human skin fibroblasts (HSF, A), AMSC (B), and AMEC (C) after overlaying agarose. HSF, AMSC, and AMEC were cultured for 5 days under both conditions with or without 3% agarose overlay, without serum, and with serum, and cell morphology was photographed. Scale bar, 50 μm. Illustrates that the agarose overlay reduced the release of HA into the medium by cultures of HSF, AMSC, and AMEC. HA concentrations were measured by ELISA assay in media from HSF, AMSC, and AMEC with and without agarose overlay, both under and without serum. Illustrates the immunolocalization of PTX3, HA, and HC1 in cell culture media containing an agarose overlay. HSF, AMSC, and AMEC were cultured in agarose overlays with or without TNF treatment and hyaluronan (red), PTX3 (green, AF; red, JL), and HC1 (green) (nuclei are Blue) was investigated. Colocalization of HC1 with HA was found in all cultures, but co-localization of PTX3 with HA or HC1 was only seen with AMSC and AMEC. Scale bar, 50 μm. Illustrates HC-HA / PTX3 complex in AMSC but not HSF under agarose overlay. Cell layer GnHCl extracts from agarose-lined HSF and AMSC cultures were subjected to PTX3 Western blots with or without NaOH treatment. M, protein ladder marker. 2 illustrates reconstitution of HC-HA / PTX3 complex on immobilized HA in vitro. iHA (˜14 μg / ml), IαI (5 μg / ml), and TSG-6 (12 μg / ml) with or without PTX3 (1, 5, or 20 μg / ml) at 37 ° C. for 2 hours. Incubated simultaneously. Sequentially, iHA (˜14 μg / ml), IαI (12 μg / ml), and TSG-6 (12 μg / ml) were incubated in reaction buffer at 37 ° C. for 2 hours, after which PTX3 ( 1, 5, or 20 μg / ml) and incubated at 37 ° for an additional 2 hours. After washing with 8M GnHCl and PBS, the iHA containing the binding components was digested with 1 unit / ml hyaluronidase at 60 ° C. for 2 hours. Samples were analyzed by Western blot using antibodies against IαI (A), TSG-6 (B), and PTX3 (C). Cell morphology of human corneal fibroblasts from DMEM / 10% FBS for 2 days (A) or DMEM / 10% FBS for 2 days ± TGF-β1 for 3 days (B) until D3 Illustrate science. Soluble HC-HA (PBS) inhibits TGFβ1 but activates TGFβ3 signaling, while insoluble HC-HA (GnHCl) signals both TGFβ1 and TGFβ3 under serum-free conditions. It demonstrates that it activates transmission and is further enhanced by TGFβ1 stimulation. Both soluble HC-HA (PBS) and insoluble HC-HA (GnHCl) illustrate that TGFβR2 and TGFβR3 expression is inhibited under TGFβ1 exposure. A, TGFβR mRNA expression. B, TGFβR protein expression. FIG. 5 illustrates the inhibition of pSMAD2 / 3 signaling nuclear translocation by HC-HA inhibition of TGFβ1 signaling. Illustrates HC-HA inhibition of alpha smooth muscle actin formation. Illustrates that the BMP6 transcript was activated by HA and soluble / insoluble HC-HA. Addition of TGFβ1 activates BMP6 transcript expression on plastic, but dramatically activates HA and BMP4 / 6 mRNA expression in HCF on soluble and insoluble HC-HA. HC-HA but not HA activates BMPR1A transcript expression in HCF loaded with TGFβ1, while additional TGFβ1 non-specifically activates BMPR1B and BMPR2 mRNA expression in HCF Illustrates that. Both soluble HC-HA (PBS) and insoluble HC-HA (GnHCl) demonstrate that BMP4 / 6 signaling is activated by pSMAD1 / 5/8. Activation of SMAD / 1/5/8 resulted in up-regulation of its downstream genes, inhibitors of DNA binding 1, 3, and 4 (ID1, ID3, and ID4), downstream targets of BMP signaling Illustrates that. HC-HA (PBS) and HC-HA (GnHCl) promoted keratocan mRNA expression 14-fold and 16-fold, respectively, demonstrating that it was significantly down-regulated by additional TGFβ1. It demonstrates that HC-HA (PBS) and HC-HA (GnHCl) promote keratocan protein expression. Illustrate that HCF expresses more ESC markers on 4X HC-HA (PBS and insoluble HC-HA (GnHCl) and on addition of TGFβ1 than on plastic). ing. Figure 3 illustrates cell viability of MC3T3-E1 cells as measured by MTT. Illustrates mineralization of MC3T3-E1 cells as measured by alizarin red staining. Illustrates morphology of MC3T3-E1 cells treated with HC-HA (A) or AMP (B) on day 13 of induction. Illustrates alizarin red staining of MC3T3-E1 cells treated with HC-HA (A) or AMP (B) on day 13 of induction. Illustrates quantitative analysis of ARS staining of MC3T3-E1 cells treated with HC-HA (A) or AMP (B) on day 13 of induction. Illustrates ALP activity (IU / L) of cells treated with HC-HA (A) and AMP (B) on day 13 of induction. Illustrate phase contrast microscopy of morphological changes in MC3T3-E1 cells after induction from day 3. (A) Non-induced cells were cultured for 7 days in αMEM w / 10% FBS. (B) MC3T3-E1 cells were cultured until confluence in a 96-well plate with flat bottom on the day after seeding (day 0). Thereafter, the cells were induced with ascorbic acid and β-glycerophosphate. Illustrate phase contrast microscopy of morphological changes of induced MC3T3-E1 cells treated with HC-HA (A) or AMP (B) from day 1 to day 7. 3 illustrates phase contrast microscopy of the spindle shape of MC3T3-E1 cell spindles induced from day 3 of induction. 3 illustrates phase contrast microscopy of the spindle shape of induced MC3T3-E1 cells treated with HC-HA (A) and AMP (B) (Day 0 to Day 6). ARS staining of induced MC3T3-E1 cells treated with HC-HA and AMP and extraction with GnHCl is illustrated. Figure 3 illustrates ARS extraction and quantification of MC3T3-E1 cells using acetic acid and 10% ammonium hydroxide. The acetic acid treated ARS extract was neutralized with 10% ammonium hydroxide and then added to a 96 well bottom clear assay plate (A) for reading on a spectrophotometer (B). . * Indicates statistical significance. Figure 3 illustrates ARS extraction and quantification of MC3T3-E1 cells using GnHCl. ARS extract with GnHCl treatment was added to a clear assay plate at the bottom of a 96 well for reading on a spectrophotometer (B). * Indicates statistical significance. Illustrates ARS staining (A) and quantification (B) of MC3T3-E1 cells treated with HC-HA on day 19 (day 18 of induction). ARS staining was treated on day 19 of culture (day 18 of induction). ARS staining (A) and quantification (B) of MC3T3-E1 cells treated with AMP are illustrated. ARS staining was treated on day 19 of culture (day 18 of induction). Illustrates the ring-like spindle observed in MC3T3-E1 cells induced on day 14 of induction. (A) Phase contrast microscopy of cell morphology of induced MC3T3-E1 cells treated with AMP after 14 days induction cultured with or without (B) transwell To illustrate. Figure 3 illustrates ARS staining of MC3T3-E1 cells induced on day 14 of induction. FIG. 9 illustrates quantification of ARS staining of MC3T3-E1 cells induced on day 14 of induction. Figure 3 illustrates ARS staining and quantification of MC3T3-E1 cells treated with AMP. (A) Phase contrast and ARS stained photographs of MC3T3-E1 cells were taken on the 21st day of culture (20th day of induction). (B) ARS staining was quantified on day 21 of culture (day 20 of induction). The symbol * indicates a statistical significance of p <0.05. Figure 3 shows a map of the differentiation of various precursors into osteoblasts using common factors added to the indicated media. Illustrates ARS staining and quantification of MC3T3-E1 cells. (FIG. 74A) Phase contrast micrographs with or without ARS staining of HUVEC, hBMMSCs, and hAM stromal stem cells from day 4 to day 21. Illustrates ARS staining and quantification of MC3T3-E1 cells. (FIG. 74B) Quantification of ARS staining. * Symbols indicate statistical significance of p <0.05 compared to negative control (neg.ctrl). Figure 3 illustrates the bone formation timeline of MC3T3-E1 cells. Illustrates ARS staining and quantification of MC3T3-E1 cells. (A) Cell morphology and ARS staining of MC3T3-E1 cells treated with AMP (Day 1, Day 2, Day 7, Day 10). (B) ARS quantification of MC3T3-E1 cells treated with AMP (Day 1, Day 2, Day 7, Day 10). * Symbols indicate statistical significance of p <0.05. Illustrates cell viability and expansion timeline by MTT assay. (A) MTT assay of MC3T3-E1 cell viability and metabolic activity on days 1, 2, and 4. * Symbols indicate statistical significance of p <0.05 from day 1. (B) BrdU assay of MC3T3-E1 cell proliferation on days 1, 2, and 16. * Symbols indicate statistical significance of p <0.05 from day 1. Figure 4 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without AMP treatment. (FIG. 78A) Cellular expression of hMSC and (FIG. 78B) MC3T3-E1. Figure 4 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without AMP treatment. (FIG. 78A) Cellular expression of hMSC and (FIG. 78B) MC3T3-E1. Figure 4 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without AMP treatment. (FIG. 78A) Cellular expression of hMSC and (FIG. 78B) MC3T3-E1. Illustrates phase contrast microscopy and quantification of the ARS assay. During the test (8 days) MC3T3-E1 cells were mineralized and deposited. ARS was then used for qualitative analysis. (FIG. 79A) CovaLink-NH 96-well plate with PBS, HA, and HC-HA immobilized. Illustrates phase contrast microscopy and quantification of the ARS assay. During the test (8 days) MC3T3-E1 cells were mineralized and deposited. ARS was then used for qualitative analysis. (FIG. 79B) Conventional 96 well plate with negative control and AGM (inducing agent) and AMP as positive controls. Illustrates phase contrast microscopy and quantification of the ARS assay. During the test (8 days) MC3T3-E1 cells were mineralized and deposited. ARS was then used for qualitative analysis. (FIG. 79C) Quantification of ARS assay. * Symbols indicate statistical significance of p <0.05 from day 1. 1 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without HC-HA / PTX3 treatment. (FIG. 80A) Key transcription factors Runx2 and Sox9 for bone formation and cartilage formation on days 1, 7, and 14. 1 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without HC-HA / PTX3 treatment. (FIG. 80B) Expression of bone morphogenetic protein (BMP) on day 14. 1 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without HC-HA / PTX3 treatment. (FIG. 80C) Chondrogenic marker Collagen2 (COL2) and osteogenic marker alkaline phosphatase (ALPL) expressed on days 7 and 14. 1 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without HC-HA / PTX3 treatment. (FIG. 80D) Abnormal development markers Collagen10 (COL10) and MMP13 expressed on day 14. 1 illustrates mRNA expression by QPCR for various genes examined after induction of differentiation with or without HC-HA / PTX3 treatment. (FIG. 80E) Day 14 osteogenic markers Collagen1 (COL1), Osterix (OSX), and bone sialoprotein (BSP). Illustrates phase contrast microscopy (FIG. 81A) and quantification (FIG. 81B) of the ARS assay after induction of differentiation with or without HC-HA / PTX3 (soluble or insoluble) treatment on day 14. Illustrates phase contrast microscopy (FIG. 81A) and quantification (FIG. 81B) of the ARS assay after induction of differentiation with or without HC-HA / PTX3 (soluble or insoluble) treatment on day 14. Illustrates CD4 + T cell activation and differentiation. Under different stimuli, native CD4 + helper T cells (Th) differentiated into Th1, Th2, Th17, or Treg and secreted different cytokines. Th1-type cytokines (eg, IFN-γ and IL-2) tend to produce a pro-inflammatory response. Illustrate procedures for measuring cell proliferation and cytokine production. Splenocytes were isolated from OT-II mice expressing transgenic TCR specific for ovalbumin (OVA) and stimulated with OVA for up to 4 days. Cell proliferation was measured by BrdU labeling and cytokine (IFN-γ and IL-2) expression was measured by respective ELISA. Illustrates nHC-HA / PTX3 inhibition of proliferation of CD4 + T cells. Spleen cells isolated from OvaT cell receptor transgenic mice were stimulated with OVA (0-10 μM) for 4 days. AM extract (AME, 25 μg / ml) and nHC-HA / PTX3 (25 μg / ml) inhibited clonal growth of activated T cells caused by increasing OVA concentration (top). Proliferation of splenocytes treated with HA, AME, or nHC-HA / PTX3 and labeled with CFSE for 4 days was measured by flow cytometry. Both AME and nHC-HA / PTX3 inhibited cell proliferation (middle) in a dose-dependent manner. Illustrates nHC-HA / PTX3 inhibition of proliferation of CD4 + T cells. Spleen cells isolated from OvaT cell receptor transgenic mice were stimulated with OVA (0-10 μM) for 4 days. 25 μg / ml nHC-HA / PTX3 inhibited proliferation of CD4 + T cells labeled with BrdU (bottom) (*, p <0.05 compared to control). Illustrates nHC-HA / PTX3 inhibition of Th1-type cytokines IFN-γ and IL-2. Splenocytes treated with PBS, 25 μg / ml HA, 25 μg / ml AME, or 25 mg / ml nHC-HA / PTX3 were stimulated with 10 μM OVA for 4 days. IFN-γ and IL-2 in the culture supernatant were measured by each ELISA. Both AME and nHC-HA / PTX3 suppressed IFN-γ and IL-2 production (* p <0.05 compared to control). Illustrates nHC-HA / PTX3 reduction of macrophage influx (labeled with enhanced green fluorescent protein, or EGFP). LPS (2 μl of 2 μg / ml) was injected into the corneal stroma of Mafia mice. Immediately, 5 ml of PBS or nHC-HA / PTX3 (1 mg / ml) was injected into each quadrant of one cornea from the same mouse via subjunctive tissue. EGFP + macrophage influx is monitored using in vivo biomicroscopy on days 1, 2, 3, and 6 following LPS treatment (top). Alternatively, the corneas of mice were treated with LPS (pre-treatment (−) or LPS treatment (3 days before pre-treatment (+)) at the same time as LPS, PBS or nHC-HA / PTX3, 4 days after LPS treatment. , Cells in the cornea were isolated by collagenase digestion and classified by FACS as EGFP- or EGFP + (macrophages) (* and **, p <0.05 and p <0.01 compared to controls, respectively) ). Illustrates nHC-HA / PTX3 polarization of macrophages towards the M2 phenotype. MRNA expression of M2 markers (Arg-1 and IL-10) and M1 markers (IL-12p40 and IL-12p35) in macrophages (EGFP +) infiltrating mouse corneas induced by LPS was quantified by qPCR. (* And **, p <0.05 and p <0.01 compared to the control, respectively). Illustrates nHC-HA / PTX3 improvement of corneal allograft survival. Mouse corneal allograft survival was markedly improved by injection of nHC-HA / PTX3 (10 μg / degree, 2 times / week, upper left) at one quadrant subconjunctival site. Further dramatic improvement was achieved by injection of nHC-HA / PTX3 (20 μg / degree, 2 times / week, upper right) at the subconjunctival site of the concentric circle. Below, photographs of PBS (21 days after surgery, left), or nHC-HA / PTX3 treatment in corneal allografts (40 days after surgery, right). Macrophage classic to express high levels of inflammatory cytokines (such as TNF-α, IL-12, and IL23) that activate Th1 and Th17 lymphocytes leading to many chronic inflammatory diseases Illustrates active M1 activation (eg elicited by IFN-γ and / or TLR ligands such as LPS). Macrophage classic to express high levels of inflammatory cytokines (such as TNF-α, IL-12, and IL23) that activate Th1 and Th17 lymphocytes leading to many chronic inflammatory diseases Illustrates active M1 activation (eg elicited by IFN-γ and / or TLR ligands such as LPS). PBS (control), HC-HA / PTX3, or AMP treatments are used to illustrate LPS-induced macrophage infiltration into the mouse cornea. Mafia mice (macrophages are EGFP +) with intramatrix injection of LPS for both eyes (5 μg). The OS was treated with PBS, and the OD was HC-HA (2 injection sites) (A), HC-HA (4 injection sites) (B), AMP (2 injection sites) (C), (AMP) ( Treated with any of the four injection sites) (D), each injection was 5 μl. Treatment was only once immediately after LPS injection. Images were taken on day 1, day 2, day 3, and day 6. Cells were counted based on the intensity of green fluorescence. Illustrates LPS-induced macrophage infiltration into the cornea of mice and its subtypes (M1 and M2) with PBS (control), nHC-HA / PTX3, or AMP treatment or pretreatment. Mafia mouse pre-treatment and treatment was the same as described in FIG. On day 4, the corneal button was excised and digested with collagenase for 2 hours at 37 ° C. EGFP-positive / negative cells were sorted by FACS. The ratio of EGFP positive macrophages to EGFP negative cells is calculated and used as an arbitrary unit to determine the degree of macrophage infiltration (A). Total RNA was extracted from sorted EGFP positive macrophages and converted to cDNAs. The expression of Arg-1, IL-10, IL-12p40, and IL-12p35 is measured by quantitative PCR (B). Schematic of injection site. The injection location is subconjunctival near the nHC-HA / PTX3 of the forehead, or AMP can reduce ALKC caused by DS in the mouse dry eye model. Illustrates HC-HA activation of IGF1-HIF1α-VEGF signaling to promote angiogenesis. When the cells are at rest, HC-HA causes a 2-6 fold increase in IGF1 mRNA and a 2 fold increase in VEGF mRNA. When cells are exposed to TGFβ (10 ng / ml), HC-HA causes a 5-12 fold increase in IGF1 mRNA and a 5-9 fold increase in VEGF mRNA. n = 4, * p <0.05, ** p <0.01. IGF1, insulin-like growth factor 1, HIF1α, hypoxia-inducible factor factor 1-α, VEGF, vascular endothelial growth factor.

(Specific chemical terms)
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the claimed subject matter belongs. Unless otherwise stated, all patents, patent applications, published applications and publications, GENBANK sequences, websites, and other publications referenced throughout this disclosure are cited as a whole. Incorporated in. If a term in this specification has multiple definitions, the definition of this title takes precedence. When referring to URLs or other such identifiers or addresses, such identifiers can be changed and specific information on the Internet can vary, but equivalent information can be found on the Internet search and / or It is known and easily available, such as by a suitable database. Reference to such things is evidence of the availability and preferred dissemination of such information.

  As used herein, ranges and amounts can be expressed as “about” a particular value or range. "About" includes the exact amount. Therefore, “about 5 μg” means “about 5 μg” or “5 μg”. In general, the term “about” includes amounts that are expected to be within experimental error.

  As used herein, the reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex is HC-HA / PTX3 formed in vitro by the assembly of component molecules of the complex. It is a complex. The process of assembling rcHC-HA / PTX3 involves the synthesis of a molecule by purification of a native protein or molecule from a biological source, reconstitution using a recombinant protein produced by recombinant methods, or in vitro synthesis. Contains. In some examples, the purified native protein used in the assembly of rcHC-HA / PTX3 is in a complex that includes other proteins (ie, multimers, multi-chain proteins, or other complexes). It is a protein. In some examples, PTX3 is purified as a multimer (eg, a homomultimer) from cells and used for assembly of the rcHC-HA / PTX3 complex.

  As used herein, a purified native HC-HA / PTX3 (nHC-HA / PTX3) complex is HC purified from a biological source such as a cell, tissue, or biological fluid. -Refers to the HA / PTX3 complex. Such complexes are generally assembled in vivo in a subject or in vitro in cells, tissues, or biological fluids from a subject, including a human or other animal.

  As used herein, PTX3 / HA complex refers to an intermediate complex formed by contacting PTX3 with immobilized HA. In the methods provided herein, the PTX3 / HA complex is one that is generated prior to the addition of HC1 to HA.

  As used herein, “hyaluronan”, “hyaluronic acid”, or “hyaluronate” (HA) is an abbreviation for D-glucuronic acid and N-acetylglucosamine (D-glucuronosyl-N-acetylglucosamine). Used interchangeably to refer to fully non-sulfated linear glycosaminoglycans (GAGs) containing repeating disaccharide units.

  As used herein, the term “high molecular weight” or “HMW” is greater than about 500 kilodaltons (kDa), such as about 500 kDa, as in high molecular weight hyaluronan (HMW HA). Refers to an HA having a weight average molecular weight of between about 800 kDa and about 10,000 kDa, between about 800 kDa and about 8,500 kDa, between about 1100 kDa and about 5,000 kDa, or between about 1400 kDa and about 3,500 kDa. Is intended. In some embodiments, the HMW HA has a weight average molecular weight of 3000 kDa or greater. In some embodiments, the HMW HA has a weight average molecular weight of 3000 kDa. In some embodiments, the HMW HA is Healon® with a weight average molecular weight of about 3000 kDa. In some embodiments, the HMW HA has a molecular weight between about 500 kDa and about 10,000 kDa. In some embodiments, the HMW HA has a molecular weight between about 800 kDa and about 8500 kDa. In some embodiments, the HMW HA has a molecular weight of about 3,000 kDa.

  As used herein, the term “low molecular weight” or “LMW” is less than 500 kDa, such as less than about 400 kDa, less than about 300 kDa, about 200 kDa, as in low molecular weight hyaluronan (LMW HA). It is intended to refer to HA having a weight average molecular weight of less than, about 200-300 kDa, or about 1-300 kDa.

  As used herein, pentraxin 3 or PTX3 protein or polypeptide includes, but is not limited to, recombinantly produced protein, synthetically produced protein, native PTX3 protein, and cell or tissue Refers to any PTX3 protein, including PTX3 protein extracted from PTX3 includes, but is not limited to, dimer, trimer, tetramer, pentamer, hexamer, tetramer, octamer, and other macromolecules produced naturally or artificially It includes multimeric forms of PTX3 (eg, homomultimers), including body shape.

  As used herein, tumor necrosis factor stimulating gene-6 (TSG-6) includes, but is not limited to, recombinantly produced protein, synthetically produced protein, native TSG-6 Refers to any TSG-6 protein or polypeptide, including protein and TSG-6 protein extracted from cells or tissues.

  As used herein, an inter-alpha inhibitor (IαI) is comprised of a light chain (ie, bikunin) and one or both heavy chains of HC1 or HC2 covalently linked by a chondroitin sulfate chain. Refers to the IαI protein. In some embodiments, the source of IαI is from serum or under stimulation in a constitutive manner by cells that produce IαI, eg, inflammatory cytokines such as IL-1 or TNF-α. From hepatocytes, amniotic epithelium or stromal cells, umbilical cord epithelium or stromal cells.

  As used herein, “hyaluronan binding protein”, “HA binding protein”, or “HABP” refers to any protein that specifically binds to HA.

  As used herein, “link module” means a hyaluronan binding domain.

  As used herein, “biological activity” refers to in vivo administration of nHC-HA / PTX3 or rcHC-HA / PTX3 complex, nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Or the in vivo activity of a composition or mixture containing nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Biological activity thus includes therapeutic effects and pharmaceutical activity of nHC-HA / PTX3 or rcHC-HA / PTX3 complexes, and compositions and mixtures thereof.

  As used herein, the terms “subject”, “individual”, and “patient” are used interchangeably. None of these terms are to be construed as requiring supervision of a medical professional (eg, doctor, nurse, physician assistant, nursing assistant, hospice worker). As used herein, a subject is any animal, including mammals (eg, humans or non-human animals) and non-mammals. In one embodiment of the methods and compositions provided herein, the mammal is a human.

  As used herein, the terms “treat”, “treating”, or “treatment” and other grammatical equivalents To alleviate, reduce or ameliorate one or more symptoms of a disease or disorder, reduce, prevent or reduce the appearance, severity or frequency of one or more additional symptoms of a disease or disorder Ameliorate or prevent the cause of metabolism underlying one or more additional symptoms of the disease or condition, inhibit the disease or condition, eg, stop the progression of the disease or condition, alleviate the disease or condition Regressing the disease or illness, alleviating the condition caused by the disease or illness, or preventing the disease or illness prophylactically and / or therapeutically Including the. In a non-limiting example, for prophylactic benefits, the rcHC-HA / PTX3 complex or composition disclosed herein is at risk of developing a specific disorder or being susceptible to a specific disease. It is administered to an individual or to an individual who reports one or more of the physiological symptoms of a disorder.

  As used herein, the “placenta” is the developing and developing uterine wall of the maternal to allow nutrients to be ingested by the maternal blood supply, waste to be expelled, and gas exchange to occur. An organ that connects the fetus. The placenta consists of three layers. The innermost placenta layer that wraps the fetus is called the amniotic membrane. The allantoic membrane is the central layer of the placenta (derived from the hindgut of the embryo), and the blood vessels starting from the navel cross this membrane. The outermost layer of the placenta (chorion) contacts the endometrium. The chorion and allanto are fused to form the chorioallantoic membrane.

  As used herein, “chorionic membrane” refers to the membrane formed by two layers, the extraembryonic mesoderm and the trophoblast. The chorion consists of two layers: the outer side formed by the trophoblast and the inner side formed by the wall-side mesoderm, the amnion touching the latter. The trophoblast is composed of the inner layer of solid cells or prismatic cells, the Langhans trophoblast cell layer, and the abundantly nucleated protoplast outer layer, syncytiotrophoblast . Avascular amniotic membrane is bound to the middle layer of the chorion.

  As used herein, “amniotic chorion” refers to a product comprising amnion and chorion. In some embodiments, the amniotic membrane and the chorion are not separated (ie, the amniotic membrane is naturally bound to the middle layer of the chorion). In some embodiments, the amniotic membrane is first separated from the chorion and then binds to the chorion during processing.

  As used herein, “umbilical cord” refers to the organ that connects the developing fetus to the placenta. The umbilical cord is mostly made of Walton jelly, a gelatinous substance made from mucopolysaccharides. The umbilical cord includes a vein that carries nutrient-rich blood containing oxygen to the fetus, and two arteries that remove deoxygenated nutrient-poor blood.

  As used herein, “placental amniotic membrane” (PAM) refers to the amniotic membrane derived from the placenta. In some embodiments, the PAM is substantially isolated.

  As used herein, “umbilical cord amniotic membrane” (UCAM) means amniotic membrane derived from the umbilical cord. UCAM is a translucent film. UCAM includes many layers, epithelial layer, basement membrane, dense layer, fibroblast layer, and sponge layer. UCAM lacks blood vessels or direct blood supply. In some embodiments, the UCAM includes a Walton jelly. In some embodiments, the UCAM includes blood vessels and / or arteries. In some embodiments, the UCAM comprises a Walton jelly and blood vessels and / or arteries.

  As used herein, the terms “purified” and “isolated” refer to materials that are substantially or essentially free from components that normally accompany it in its natural state (eg, nHC-HA / PTX3 complex). In some embodiments, “purified” or “isolated” is, in its native state, usually free of about 50% or more of its components, eg, in its natural state, usually in it. About 50%, about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 91%, about 92%, about 93% , About 94%, about 95%, about 96%, about 97%, about 98%, or about 99% free material (eg, nHC-HA / PTX3 complex).

Overview: nHC-HA / PTX3 and rcHC-HA / PTX3 complex Hyaluronan (HA) is linked to D-glucuronic acid and N-acetyl-D-glucosamine via GlcUA--β1,3-GlcNAc-β1,4-linkages. It is a fully non-sulfated linear glycosaminoglycan (GAG) composed of repeating disaccharide subunit units. HA is synthesized by HA synthase (eg, HAS1, HAS2, and HAS3) and deposited in the extracellular matrix, contributing to the structural integrity of the tissue and more by interacting with proteins including cell surface receptors. It also controls cell processes. The molecular weight of HA generally ranges in size from about 200 to about 10,000 kDa. Standard levels of HA are maintained in tissues through biosynthetic balance by HAS enzymes and catabolism by hyaluronidases such as Hyal1.

  High molecular weight HA (HMW HA), typically 500 kDa and higher, promotes cell cessation and structural integrity of tissues such as the cartilage and vitreous body (body fluids) of the eye and is associated with wound healing in fetuses without scars. In certain instances, HMW HA inhibits pro-inflammatory mediators and angiogenic gene expression.

  In certain pathogenic diseases, HMW HA is broken down into smaller fragments and oligosaccharides (eg, by hyaluronidase or free radical oxidation). LMW HA fragments promote vascular endothelial cell proliferation, migration, collagen synthesis, sprout formation, and angiogenesis in rat skin by stimulating gene expression of mediators of pro-inflammatory and pro-angiogenesis, Stimulates myocardial infarction as well as a cryo-injured skin graft model.

  The biological function of HA is mediated through the interaction of HA with HA binding protein (HABP), also called hyaladherins. Such proteins include, but are not limited to, tumor necrosis factor alpha stimulating gene 6 (TSG-6), aggrecan, versican, neurocan, brevican, LYVE-1, CD44, and inter alpha inhibitor (I alpha I). In some examples, the HABP includes a link module domain that binds to the HA. TSG-6, aggrecan, versican, neurocan, brevican, LYVE-1, and CD44 are typical HABPs containing link modules.

  IαI contains two heavy chains (HC1 and HC2), both of which are linked by an ester bond to the chondroitin sulfate chain attached to the light chain (ie, bikunin). In some examples, the HA is covalently attached to the IαI heavy chain to form a covalent complex comprising one or both of the IαI HCs (hereinafter “HC-HA”). In certain examples, IαI is found in serum and / or cells that produce IαI under stimulation in a constitutive manner by inflammatory cytokines such as IL-1 or TNF-α, eg, Obtained from hepatocytes, amniotic epithelium or stromal cells, umbilical cord epithelium or stromal cells.

  In certain instances, TSG-6 promotes and catalyzes the transmission of IαI HC1 and HC2 to HA and / or transmits IαI HC1 and HC2 to HA. TSG-6 forms a stable complex containing immobilized HA (TSG-6 · HA), which leads to transmission of HC1 and HC2 to HA to form the HC-HA complex, and the complex Resulting in the release of TSG-6 from Expression of TSG-6 is often caused by inflammatory mediators such as TNF-α and interleukin 1 and during processes such as inflammation such as ovulation and cervical ripening.

  The amniotic membrane (AM) regulates adult wound healing and promotes tissue regeneration. In certain instances, AM promotes epithelialization and inhibits interstitial inflammation, angiogenesis and scarring. AM includes, but is not limited to, persistent epithelial defects, deep corneal ulcers, infectious keratitis, symptomatic bullous keratopathy, acute Stevens-Johnson syndrome / toxic epidermal necrosis (SJS / TEN), cornea Eyes that require reconstitution of the cornea and conjunctiva surfaces, including limbal stem cell defects, pterygium, ruptured plaques, conjunctival laxity, Ryukyu adhesion, formic reconstruction, and conjunctival tumors It has been successfully used as a surgical graft or temporary biological patch for the treatment of various diseases.

  The avascular stromal matrix of AM contains large amounts of HA and constitutively expresses IαI (Zhang et al. (2012) J. Biol. Chem. 287 (15): 12433-44). In AM, HMW HA forms an nHC-HA complex (He et al. (2009) J. Biol. Chem. 284 (30): 20136-20146). As shown herein in the examples provided, this nHC-HA complex contains pentraxin 3, PTX3 (FIG. 1) and is therefore referred to herein as “nHC-HA / PTX3 complex. Also called “body”. Natural HC-HA / PTX3 complexes extracted from AM exhibit suppression of TGF-β promoter activity, promotion of macrophage cell death, and suppression of vascular development. Thus, the nHC-HA / PTX3 complex of AM plays an active role in the anti-inflammatory action, anti-scarring action and anti-angiogenic action of AM.

  As described herein, nHC-HA / PTX3 complexes are also found in the umbilical cord (UC). The UC HC-HA / PTX3 complex has its biochemical composition with respect to HA content and presence and / or relative abundance of various components of the complex including proteoglycans such as small leucine-rich proteoglycans (SLRP). It differs in. In some embodiments, the SLRP is decorin, biglycan, and / or osteoadherin. As described herein, the conjugates differ in content with respect to the presence of certain sulfated glycosaminoglycans such as keratan sulfate. In addition, as described herein, complexes isolated from AM or UC using a variety of extraction methods (eg, PBS vs. GnHCl extraction) may have different biochemical compositions and biological A composite with the properties resulted. In certain instances, complexes isolated from insoluble fractions by GnHCl extraction from umbilical cord tissue have been shown to exhibit improved characteristics.

  PTX3 is a multimeric protein that has been shown to interact directly with TSG-6 and IαI HC. PTX3 is upregulated in response to inflammatory regulators and has been shown to play an important role in the organization of HA in the extracellular matrix of cumulus ophorous during oocyte maturation. As demonstrated herein, PTX3 is found in the amniotic and umbilical nHC-HA complex (ie, nHC-HA / PTX3) and plays a critical role in the polarization of M2 macrophages.

  M1 macrophages, or classically activated pro-inflammatory macrophages, are induced by interferon (IFN) alone or in combination with lipopolysaccharide (LPS) or tumor necrosis factor (TNF) α. M1 macrophages are typically characterized by high expression of interleukin 12 (IL-12) and IL-23 and low levels of IL-10. In contrast, M2 macrophages or “selectively activated” macrophages exhibit characteristics of wound healing and tissue regeneration, with low IL-12 / IL-23 and high IL-12, and the same ratio of IL-10 pairs Characterized by IL-10. In certain instances, M2 macrophages are further equipped with high expression of TGF-β.

  The examples provided herein demonstrate that PTX3 binds directly to immobilized HA as evidenced by resistance to dissociating agents. It is herein described that an in vitro reconstituted complex of HA bound to PTX3 exhibits various properties when compared to an in vitro reconstituted complex of HA bound to TSG-6. Has been proven. For example, in some embodiments, the PTX3 / HA complex promotes the binding of LPS-stimulated macrophages without aggregation and induces IL-10 expression in LPS-stimulated macrophages. In some embodiments, the PTX3 / HA complex disclosed herein is approximately equal to about 10% in LPS-stimulated macrophages compared to IL-10 expression in the absence of the PTX3 / HA complex. 5%, 10%, 15%, 20%, 25%, 30%, 35% 40% 45% 50% 55% 60% 65%, 70%, 75%, 80%, 85%, 90%, 95% Or increase expression of IL-10 by 100%. In contrast, in some embodiments, the TSG-6 / HA complex reduces cellular binding, promotes aggregation of LPS-stimulated macrophages, and expression of IL-10 in LPS-stimulated macrophages Do not induce. In addition, in some embodiments, TSG-6 pre-bound to HA inhibits subsequent binding of PTX3 to the complex. In some embodiments, both TSG-6 / HA and PTX3 / HA complexes reduced IL-12 expression in LPS-stimulated macrophages. In some embodiments, a PTX3 / HA complex or TSG-6 / HA complex disclosed herein is an IL-12 in the absence of a PTX3 / HA complex or TSG-6 / HA complex. Compared to expression, expression of IL-12 in macrophages stimulated with LPS was reduced by about 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50 %, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100%, decrease or inhibit. In some embodiments, both TSG-6 / HA complex and PTX3 / HA complex increased expression of IL-23 in macrophages stimulated with LPS / IFNγ. In some embodiments, the PTX3 / HA complex or TSG-6 / HA complex disclosed herein is IL-23 in the absence of the PTX3 / HA complex or TSG-6 / HA complex. Compared to expression, expression of IL-23 was reduced to approximately 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45 in macrophages stimulated with LPS / IFNγ. %, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100%, decrease or inhibit.

  In addition, the rcHC-HA / PTX3 complex reconstituted in vitro is obtained by using HA in which the rcHC-HA / PTX3 complex is pre-bound to TSG-6 in the presence of IαI, and then PTX3 or PTX3. It has been demonstrated herein to have different biological activities depending on whether it is formed by adding pre-bound HA followed by TSG-6 containing IαI. An exemplary method for reconstitution of rcHC-HA / PTX3 complexes formed using HA pre-bound to TSG-6 or HA pre-bound to PTX3 is described herein. Provided in. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to TSG-6 results in LPS stimulated macrophage aggregation. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 promotes the binding of LPS-stimulated macrophages without aggregation.

  In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 inhibits expression of M1 macrophage markers such as IL-12 and IL-23. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 is compared to IL-12 expression in the absence of the rcHC-HA / PTX3 complex. Reducing the expression of IL-12 in macrophages stimulated with LPS. In some embodiments, the rcHC-HA / PTX3 complex disclosed herein is LPS-stimulated macrophages compared to IL-12 expression in the absence of the rcHC-HA / PTX3 complex. IL-12 expression in about 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70 %, 75%, 80%, 85%, 90%, 95%, or 100% decrease or inhibit. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 is compared to IL-12 expression in the absence of the rcHC-HA / PTX3 complex. Reduce or inhibit IL-23 expression in macrophages stimulated with LPS / IFN-γ. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 is compared to IL-23 expression in the absence of the rcHC-HA / PTX3 complex. In macrophages stimulated with LPS / IFNγ, the expression of IL-23 is about 5% 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 100% decrease or inhibit. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to PTX3 replicates the activity of the nHC-HA / PTX3 complex separated from the amniotic membrane.

  In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to TSG-6 reduces or inhibits expression of M1 macrophage markers such as IL-12 Increases the expression of IL-23. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to TSG-6 reduces or inhibits IL-12 expression. In some embodiments, the rcHC-HA / PTX3 complex formed using immobilized HA pre-bound to TSG-6 increases IL-23 expression.

  Provided herein are methods and uses thereof for generating reconstituted HC-HA / PTX3 complexes using immobilized HA pre-bound to PTX3. Similarly, immobilized HA complexes pre-bound to PTX3 and uses thereof are also provided herein. Further provided herein are methods and uses thereof for generating reconstituted HC-HA / PTX3 complexes using immobilized HA pre-bound to TSG-6. In some embodiments, a reconstituted HC-HA / PTX3 complex provided herein includes, but is not limited to, an immune response, adhesion, scar, blood vessel that leads to inflammation, autoimmunity or immune rejection Treatments such as neoplasia, diseases requiring cell or tissue recovery, tissue reperfusion injury due to ischemia including myocardial infarction and stroke, and inhibition, reduction, prevention, or reduction of risk caused by it Are administered to treat various diseases or conditions. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat inflammation. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat a scar. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat angiogenesis. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat an immune response that leads to autoimmunity or immune rejection. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat a disease that requires inhibition of cell adhesion. In some embodiments, the reconstituted HC-HA / PTX3 complex provided herein is administered to treat a disease requiring cell or tissue regeneration.

  In addition, the examples provided herein show that the ability of the HC-HA / PTX3 complex not only maintains stem cells in an undifferentiated state, but also a young precursor in a human corneal fibroblast model. Demonstrates that it induces adult differentiated fibroblasts. Human corneal fibroblasts differentiate from corneal parenchymal cells after addition of exogenous TGF-β1 to become myofibroblasts that further differentiate to form scars. The data provided herein demonstrates that culturing cells in the presence of HC-HA prevented the cells from differentiating into myofibroblasts under TGF-β1 stimulation. In the absence of TGF-β1, the HC-HA / PTX3 complex returns human corneal fibroblasts to keratocytes that express keratocan and CD34. Many neural crest cell markers such as Osr2, FGF10, and Sox9, and c-myc, KLF4, Nanog, Nestin, Oct4, although lacking keratocan expression in the presence of human corneal fibroblasts of TGF-β1 Reprogrammed to younger progenitors that express embryonic stem cell markers such as Rex-1, Sox-2, and SSEA-4.

  The transcription factors Sox2, Oct4, c-Myc, and KLF4 are known to play an important role in the induction of precursor stem cells (iPSCs) from adult differentiated cells. Thus, in some embodiments, the HC-HA / PTX3 complexes provided herein are used to reprogram adult differentiated cells into iPSCs. In some embodiments, induction of iPSCs using the HC-HA / PTX3 complex in combination with one or more of Sox2, Oct4, c-Myc, and KLF4 results in these 4 without HC-HA / PTX3. It is performed with much higher efficiency than conventional methods using two transcription factors. In some embodiments, the addition of the HC-HA / PTX3 complex is by turning off TGF-β signaling to prevent differentiation and to promote reprogramming to young progenitor cells such as iPSCs In turn, stem cell induction is promoted by turning on BMP signaling. In some embodiments, the addition of the HC-HA / PTX3 complex promotes stem cell induction and stem cell marker induction by reprogramming cells to young progenitors. In some embodiments, the addition of the HC-HA / PTX3 complex helps maintain stem cell characteristics during expansion in vitro and thus support cells made of mouse embryonic fibroblasts The need to use layers is eliminated. Thus, in some embodiments, the HC-HA / PTX3 complex is a carrier or scaffold to help deliver expanded stem cells in vitro to a human patient to facilitate the efficacy of the stem cell therapy. Used as.

(Method for producing isolated nHC-HA / PTX3 complex)
Disclosed herein is a method for producing an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3).

  In some embodiments, the isolated nHC-HA / PTX3 complex is isolated from amnion tissue. In some embodiments, the isolated nHC-HA / PTX3 complex is isolated from amniotic membrane or umbilical cord. In some embodiments, the isolated nHC-HA / PTX3 complex is a fresh, frozen, or pre-frozen placenta amniotic membrane (PAM), fresh, frozen, or pre-frozen umbilical cord. Amniotic membrane (UCAM), fresh, frozen or pre-frozen placenta, fresh, frozen or pre-frozen umbilical cord, fresh, frozen or pre-frozen chorion, fresh, frozen Or isolated from previously frozen amnion chorion, or any combination thereof. Such tissue can be obtained from any mammal, such as, but not limited to, humans, non-human primates, cows, or pigs.

  In some embodiments, nHC-HA / PTX3 is purified by any suitable method. In some embodiments, the nHC-HA / PTX3 complex may be centrifuged (eg, ultracentrifugation, gradient centrifugation), chromatography (eg, ion exchange, affinity, size exclusion, and hydroxyapatite chromatography). ), Gel filtration, or differential solubility, ethanol precipitation, or other techniques available for protein purification (eg, Scopes, Protein Purification Principles and Practice 2nd Edition, Springer) -Verlag, New York, 1987; Higgins, S. J. and Hames, B. D. (eds.), Protein Expression: A Prac. and Deutscher Press, 1999; and Deutscher, M. P., Simon, M. I., Abelson, J. N. (eds.), Guide to Protein Purity: M ed. 182), Academic Press, 1997, all incorporated herein by reference).

  In some embodiments, nHC-HA / PTX3 is isolated from the extract. In some embodiments, the extract is prepared from an amniotic extract. In some embodiments, the extract is prepared from an umbilical cord extract. In some embodiments, the umbilical cord extract comprises umbilical cord stroma and / or Walton jelly. In some embodiments, the nHC-HA / PTX3 complex is included in an extract prepared by ultracentrifugation. In some embodiments, the nHC-HA / PTX3 complex is included in an extract prepared by ultracentrifugation using a CsCl / 4-6M guanidine HCl gradient. In some embodiments, the extract is prepared by at least two ultracentrifugations. In some embodiments, the extract is prepared by more than two ultracentrifugation (ie, nHC-HA / PTX3 2nd). In some embodiments, the extract is prepared by at least 4 ultracentrifugation (ie, nHC-HA / PTX3 4th). In some embodiments, the nHC-HA / PTX3 complex comprises a small leucine-rich proteoglycan. In some embodiments, the nHC-HA / PTX3 complex comprises HC1, HA, PTX3, and / or a small leucine-rich proteoglycan.

  In some embodiments, ultracentrifugation is performed on extracts prepared by extraction in isotonic solutions. In some embodiments, the isotonic solution is PBS. For example, in some embodiments, the tissue is homogenized in PBS to produce a homogenized sample. The homogenized sample is separated into a soluble part and an insoluble part by centrifugation. In some embodiments, ultracentrifugation is performed on soluble portions of tissue extracted with PBS. In such embodiments, nHC-HA / PTX3 purified by ultracentrifugation of tissue extracted with PBS is referred to as an nHC-HA / PTX3 soluble complex. In some embodiments, the nHC-HA soluble complex comprises a small leucine-rich proteoglycan. In some embodiments, the nHC-HA / PTX3 soluble complex comprises HC1, HA, PTX3, and / or a small leucine-rich proteoglycan.

  In some embodiments, ultracentrifugation is performed on extracts prepared by direct guanidine HCl extraction (eg, 4-6M GnHCl) of amniotic membrane and / or umbilical cord tissue. In some embodiments, the GnHCl extract tissue is then centrifuged to produce a GnHCl soluble portion and a GnHCl insoluble portion. In some embodiments, ultracentrifugation is performed on the GnHCl soluble portion. In such embodiments, nHC-HA / PTX3 purified by ultracentrifugation of tissue extracted with guanidine HCl is referred to as an nHC-HA / PTX3 insoluble complex. In some embodiments, the insoluble complex of nHC-HA comprises a small leucine-rich proteoglycan. In some embodiments, the insoluble complex of nHC-HA / PTX3 comprises HC1, HA, PTX3, and / or a small leucine-rich proteoglycan.

  In some embodiments, ultracentrifugation is performed on extracts prepared by further guanidine HCl extraction of insoluble portions of tissue extracted with PBS. For example, in some embodiments, the tissue is homogenized in PBS to produce a homogenized sample. The homogenized sample is then separated into soluble and insoluble parts by centrifugation. The insoluble portion is extracted in guanidine HCl (eg 4-6M GnHCl) and centrifuged to produce soluble and insoluble portions of guanidine HCl. In some embodiments, ultracentrifugation is performed on a guanidine HCl soluble portion. In such embodiments, nHC-HA / PTX3 purified by ultracentrifugation of tissue extracted with guanidine HCl is referred to as an nHC-HA / PTX3 insoluble complex. In some embodiments, the insoluble complex of nHC-HA comprises a small leucine-rich proteoglycan. In some embodiments, the insoluble complex of nHC-HA / PTX3 comprises HC1, HA, PTX3, and / or a small leucine-rich proteoglycan.

  In some embodiments, a method of purifying an isolated nHC-HA / PTX3 extract comprises the following steps: (a) To produce a CsCl mixture, with an initial density of 1.35 g / ml. Dissolving an extract (eg, prepared by a soluble or insoluble method described herein) isolated in CsCl / 4-6M guanidine HCl, (b) producing a first purified extract Centrifuge the CsCl mixture at 125,000 times g for 15 hours at 15 ° C., (c) extract the first purified extract to produce a dialysate. Dialysis it against distilled water, thereby removing CsCl guanidine HCl. In some embodiments, the method of purifying the isolated extract further comprises (d) converting the dialysate to 3 ° C. for 1 hour at 0 ° C. to produce a first dialysate / ethanol mixture. Mixing with 95% (v / v) volume of ethanol containing 1.3% (w / v) potassium acetate, (e) 15,000-fold to produce a second purified extract c. centrifuging the first dialysate / ethanol mixture at g; and (f) extracting the second purified extract. In some embodiments, the method of purifying the isolated extract further comprises the following steps: (g) a second purified extract to produce a second purified extract / ethanol mixture. Washing the extract with ethanol (eg, 70% ethanol), (h) centrifuge the second purified extract / ethanol mixture into a centrifuge to produce a third purified extract. And (i) extracting a third purified extract. In some embodiments, the method of purifying the isolated extract further comprises the following steps: (j) a third purified extract to produce a third purified extract / ethanol mixture. Washing the extracted extract with ethanol (eg, 70% ethanol); (k) centrifuging the third purified extract / ethanol mixture into a centrifuge to produce a fourth purified extract. And (l) extracting a fourth purified extract. In some embodiments, the purified extract comprises an nHC-HA / PTX3 complex.

  In some embodiments, the nHC-HA / PTX3 complex is purified by immunoaffinity chromatography. In some embodiments, anti-HC1 antibodies, anti-HC2 antibodies, or both are generated and attached to a stationary support. In some embodiments, the crude HC-HA complex (ie, mobile phase) passes over the support. In a specific example, the HC-HA complex comprises (eg, (a) anti-HC1 antibody and HC1, (b) anti-HC2 antibody and HC2, (c) anti-PTX antibody and PTX3, (d) anti-SLRP antibody. And SLRP, or (e) any combination thereof) binds to the antibody. In some embodiments, the support is washed (eg, with PBS) to remove any unbound or loosely-bound molecules. In some embodiments, the support is a solution that allows elution of the nHC-HA / PTX3 complex from the support (eg, 1% SDS, 6M guanidine-HCl, or 8M urea). Washed.

  In some embodiments, the nHC-HA / PTX3 complex is purified by affinity chromatography. In some embodiments, HABP is generated and attached to a stationary support. In some embodiments, the crude nHC-HA / PTX3 complex (ie, mobile phase) passes over the support. In a particular example, the nHC-HA / PTX3 complex binds to HABP. In some embodiments, the support is washed (eg, with PBS) to remove any unbound or loosely bound molecules. In some embodiments, the support is washed with a solution that allows elution of the HC-HA complex from the support.

  In some embodiments, the nHC-HA / PTX3 complex comprises HABP affinity chromatography and an anti-HC1 antibody, an anti-HC2 antibody, an anti-PTX3 antibody, an antibody against a combination of SLRP or SLRP, or of these antibodies Purified by a combination of immunoaffinity chromatography using any combination.

  In some embodiments, the nHC-HA / PTX3 complex is purified from the insoluble fraction as described herein using one or more antibodies. In some embodiments, the nHC-HA / PTX3 complex is purified from the insoluble fraction using an anti-SLRP antibody as described herein.

  In some embodiments, the nHC-HA / PTX3 complex is purified from the soluble fraction as described herein. In some embodiments, the nHC-HA / PTX3 complex is purified from the soluble fraction as described herein using an anti-PTX3 antibody.

  In some embodiments, the nHC-HA / PTX3 complex comprises a small leucine-rich proteoglycan (SLRP). In some embodiments, the nHC-HA / PTX3 complex comprises a Type I, Type II, Type III SLRP. In some embodiments, the small leucine-rich proteoglycan is selected among type I SLRPs such as decorin and biglycan. In some embodiments, small leucine-rich proteoglycans are among type II SLRPs such as fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, and osteoadherin. Selected from. In some embodiments, the small leucine-rich proteoglycan is selected among type III SLRPs such as epipican and osteoglycin. In some embodiments, the small leucine-rich proteoglycan is selected from among bikunin, decorin, biglycan, and osteoadherin. In some embodiments, the small leucine-rich protein comprises a glycosaminoglycan. In some embodiments, the small leucine-rich proteoglycan comprises keratan sulfate.

(Method for producing rcHC-HA / PTX3 complex)
Disclosed herein are methods for generating a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3) with or without SLRP. Similarly, rcHC-HA / PTX3 complexes and intermediate combinations of components produced by such methods are disclosed herein.

  In some embodiments, the method of generating a reconstituted HC-HA / PTX3 complex comprises (a) immobilized high molecular weight hyaluronan under suitable conditions to form a PTX3 / HA complex. Contacting (HMW HA) with pentraxin 3 (PTX3); and (b) contacting PTX3 / HA complex with IαI and tumor necrosis factor-stimulated gene-6 (TSG-6). including. Provided herein are rcHC-HA / PTX3 complexes produced by such methods. In some embodiments, TSG-6 catalyzes the transmission of heavy chain 1 (HC1) of inter alpha inhibitor (IαI) to HA. In some embodiments, IαI HC1 forms a covalent bond with HA. In some embodiments, steps (a) and (b) of the method are performed sequentially in sequence.

  In some embodiments, the method of producing a reconstituted HC-HA / PTX3 complex comprises contacting the PTX3 / HA complex with IαI and TSG-6. In some embodiments, TSG-6 catalyzes the transmission of heavy chain 1 (HC1) of inter alpha inhibitor (IαI) to HA. Provided herein are rcHC-HA / PTX3 complexes produced by such methods. In some embodiments, IαI HC1 forms a covalent bond with HA.

  In some embodiments, a method of generating a complex of HA bound to PTX3 comprises immobilizing high molecular weight hyaluronan (HMW HA) and pentraxin 3 (under appropriate conditions to form a PTX3 / HA complex. Contacting with PTX3). Provided herein are PTX3 / HA complexes produced by such methods.

  In some embodiments, the method of generating a reconstituted HC-HA / PTX3 complex comprises (a) IαI and TSG-6 to form an HC-HA complex pre-bound to TSG-6. Contacting the immobilized high molecular weight hyaluronan (HMW HA) comprising HA with HA, and (b) the HC-HA complex under suitable conditions to form the rcHC-HA / PTX3 complex, Contacting with PTX3). An rcHC-HA / PTX3 complex produced by such a method is provided herein. In some embodiments, IαI HC1 forms a covalent bond with HA. In some embodiments, steps (a) and (b) of the method are performed sequentially in sequence. In some embodiments, the method comprises contacting an HC-HA complex pre-bound to TSG-6 with PTX3.

  In some embodiments, the method comprises first contacting high molecular weight hyaluronan (HMW HA) with pentraxin 3 (PTX3) under conditions suitable to form a PTX3 / HA complex, followed by PTX3 / Contacting the HA complex with IαI and TSG-6.

  In some embodiments, the IαI protein and TSG-6 protein are about 1: 1, 2: 1, 3: 1, 4: 1, 5: 1, 6: 1, 7: 1, 8: 1, 9. The complex is contacted at a molar ratio of 1: 10: 1, 15: 1, or 20: 1 (IαI: TSG-6). In some embodiments, the ratio of IαI: TSG-6 is about 1: 1 to about 20: 1, such as about 1: 1 to about 10: 1, eg, about 1: 1 to about 5: 1. For example, in the range of about 1: 1 to about 3: 1. In some embodiments, the ratio of IαI: TSG-6 is 3: 1 or greater. In some embodiments, the ratio of IαI: TSG-6 is 3: 1.

  In some embodiments, steps (a) and (b) of the method are performed sequentially in sequence. In some embodiments, the method comprises contacting the PTX3 / HA complex with IαI and TSG-6.

  In a specific example, TSG-6 interacts with IαI to form a covalent complex between IαI HC1 and HC2 (ie, HC1 • TSG-6 and HC2 • TSG-6). In a particular example, in the presence of HA, HC is transferred to HA to form rcHC-HA. In some embodiments, the TSG-6 · HC1 complex is added to the pre-bound PTX3 / HA complex to catalyze the transfer of HC1 to the HA. In some embodiments, the method comprises first contacting immobilized high molecular weight hyaluronan (HMW HA) with pentraxin 3 (PTX3) under conditions suitable to form a PTX3 / HA complex; Contacting the PTX3 / HA complex with the HC1 • TSG-6 complex. In some embodiments, the combination of HC1 • TSG-6 complex and HC2 • TSG-6 complex is added to the PTX3 / HA complex.

  In some embodiments, contacting PTX3 with immobilized HMW HA comprises at least 10 minutes, at least 30 minutes, at least 1 hour, at least 2 hours, at least 3 hours, at least 4 hours, at least 5 hours, at least 6 Occurs for at least 12 hours, or at least 24 hours or more. In some embodiments, the step of contacting PTX3 with the immobilized HMW HA occurs for at least 2 hours or more. In some embodiments, contacting PTX3 with immobilized HMW HA occurs for at least 2 hours. In some embodiments, the step of contacting PTX3 to the immobilized HMW HA occurs at 37 ° C. In some embodiments, contacting PTX3 to immobilized HMW HA occurs with 5 mM MgCl 2 in PBS.

  In some embodiments, contacting the PTX3 / HA complex comprising IαI and TSG-6 with HA comprises at least 10 minutes, at least 30 minutes, at least 1 hour, at least 2 hours, at least 3 hours, at least 4 Occurs for at least 5 hours, at least 6 hours, at least 12 hours, or at least 24 hours or more. In some embodiments, contacting the PTX3 / HA complex with the HC1 • TSG-6 complex and / or the HC2 • TSG-6 complex comprises at least 10 minutes, at least 30 minutes, at least 1 hour, at least 2 It occurs for at least 3 hours, at least 4 hours, at least 5 hours, at least 6 hours, at least 12 hours, or at least 24 hours or more. In some embodiments, the step of contacting the PTX3 / HA complex with the HC1 • TSG-6 complex and / or HC2 • TSG-6 complex occurs for at least 2 hours or more. In some embodiments, contacting the PTX3 / HA complex with the HC1 • TSG-6 complex and / or the HC2 • TSG-6 complex occurs for at least 2 hours. In some embodiments, the step of contacting the PTX3 / HA complex with the HC1 • TSG-6 complex and / or the HC2 • TSG-6 complex occurs at 37 ° C. In some embodiments, the step of contacting the PTX3 / HA complex with the HC1 • TSG-6 complex and / or HC2 • TSG-6 complex occurs with 5 mM MgCl 2 in PBS.

  In some embodiments, the method comprises high molecular weight hyaluronan (HMW HA), pentraxin 3 (PTX3) protein, heavy chain 1 (HC1) under conditions suitable to form an HC-HA / PTX3 complex. ) Containing inter-alpha inhibitor (IαI) protein and tumor necrosis factor alpha-stimulated gene 6 (TSG-6). In some embodiments, the step of contacting the HMW HA with PTX3, IαI, and TSG-6 comprises at least 10 minutes, at least 30 minutes, at least 1 hour, at least 2 hours, at least 3 hours, at least 4 hours, It occurs for at least 5 hours, at least 6 hours, at least 12 hours, or at least 24 hours or more. In some embodiments, contacting HMW HA with PTX3, IαI, and TSG-6 occurs at 37 ° C. In some embodiments, contacting HMW HA with PTX3, IαI, and TSG-6 occurs at 5 mM MgCl 2 in PBS.

  In some embodiments, the method comprises subjecting high molecular weight hyaluronan (HMW HA) to pentraxin 3 (PTX3) protein, heavy chain 1 (under appropriate conditions to form an HC-HA / PTX3 complex. A step of sequentially contacting an inter-α inhibitor (IαI) protein containing HC1) and a gene 6 (TSG-6) stimulated with tumor necrosis factor α in any order. In some embodiments, the step of contacting the HMW HA with PTX3, IαI, and TSG-6 comprises at least 10 minutes, at least 30 minutes, at least 1 hour, at least 2 hours, at least 3 hours, at least 4 hours, It occurs for at least 5 hours, at least 6 hours, at least 12 hours, or at least 24 hours or more. In some embodiments, contacting HMW HA with PTX3, IαI, and TSG-6 occurs at 37 ° C. In some embodiments, contacting HMW HA with PTX3, IαI, and TSG-6 occurs with 5 mM MgCl 2 in PBS.

  In some embodiments, the method for production of the rcHC-HA / PTX3 complex further comprises the addition of one or more small leucine-rich proteoglycans (SLRP). In some embodiments, the method of producing a reconstituted HC-HA / PTX3 complex comprises (a) immobilized high molecular weight hyaluronan (under appropriate conditions to form a PTX3 / HA complex). Contacting HMW HA) with pentraxin 3 (PTX3), (b) contacting PTX3 / HA complex with gene-6 (TSG-6) stimulated with IαI and tumor necrosis factor, (c) PTX3 Contacting the / HA complex with one or more SLRPS. Provided herein are rcHC-HA / PTX3 complexes produced by such methods. In some embodiments, TSG-6 catalyzes the transmission of heavy chain 1 (HC1) of inter-alpha inhibitor (IαI) to HA. In some embodiments, IαI HC1 forms a covalent bond with HA. In some embodiments, steps (a), (b), and (c) of the method are performed sequentially in sequence. In some embodiments, steps (a), (b), and (c) of the method are performed simultaneously. In some embodiments, step (a) of the method is performed, followed by sequential steps (b) and (c) of the method. In some embodiments, step (a) of the method is performed, and then steps (b) and (c) of the method are performed simultaneously.

  In some embodiments, the method of generating a reconstituted HC-HA / PTX3 complex comprises (a) IαI and TSG-6 to form an HC-HA complex pre-bound to TSG-6. Contacting the immobilized high molecular weight hyaluronan (HMW HA) comprising HA with (HA), contacting the HC-HA complex with pentraxin 3 (PTX3), and (c) rcHC-HA / PTX3 complex Contacting the HC-HA complex with one or more SLRPS under suitable conditions to form a body. Provided herein are rcHC-HA / PTX3 complexes produced by such methods. In some embodiments, IαI HC1 forms a covalent bond with HA. In some embodiments, the method comprises contacting PTX3 with an HC-HA complex pre-bound to TSG-6. In some embodiments, steps (a), (b), and (c) of the method are performed sequentially in sequence. In some embodiments, steps (a), (b), and (c) of the method are performed simultaneously. In some embodiments, step (a) of the method is performed, followed by sequential steps (b) and (c) of the method. In some embodiments, step (a) of the method is performed, and then steps (b) and (c) of the method are performed simultaneously.

  In some embodiments, the SLRP is selected from type I, type II, or type III SLRP. In some embodiments, the SLRP is selected from among type I SLRPs, such as decorin and biglycan. In some embodiments, the small leucine-rich proteoglycan is a type II SLRP such as fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, and osteoadherin. It is selected from the inside. In some embodiments, the small leucine-rich proteoglycan is selected among type III SLRPs such as epipican and osteoglycin. In some embodiments, the small leucine-rich proteoglycan is selected from among bikunin, decorin, biglycan, and osteoadherin. In some embodiments, the small leucine-rich protein comprises a glycosaminoglycan. In some embodiments, the small leucine-rich proteoglycan comprises keratan sulfate.

  PTX3

  In some embodiments, the PTX3 used in the method is isolated from a cell or a plurality of cells (eg, a tissue extract). Typical cells suitable for expression of PTX3 include, but are not limited to, animal cells (including but not limited to mammalian cells, primate cells, human cells, rodent cells, insect cells, bacteria, And yeast cells) and plant cells (including but not limited to algae, angiosperms, gymnosperms, ferns and moss plants). In some embodiments, the PTX3 used in the method is isolated from human cells. In some embodiments, the PTX3 used in the method is isolated from cells stimulated with one or more inflammatory cytokines to upregulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the PTX3 used in the method is isolated from amniotic cells. In some embodiments, the PTX3 used in the method is isolated from amniotic cells from the umbilical cord. In some embodiments, amniotic cells are stimulated with more inflammatory cytokines to upregulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the PTX3 used in the method is isolated from umbilical cord cells. In some embodiments, umbilical cord cells are stimulated with more inflammatory cytokines to upregulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the PTX3 used in the method is isolated from amnion epithelial cells. In some embodiments, the PTX3 used in the method is isolated from umbilical cord epithelial cells. In some embodiments, amniotic epithelial cells or umbilical cord epithelial cells are stimulated with more inflammatory cytokines to up-regulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the PTX3 used in the method is isolated from amnion stromal cells. In some embodiments, the PTX3 used in the method is isolated from umbilical cord stromal cells. In some embodiments, amniotic stromal cells or umbilical cord stromal cells are stimulated with more inflammatory cytokines to up-regulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the PTX3 used in the method is a native PTX3 protein isolated from cells. In some embodiments, the cells are stimulated with more inflammatory cytokines to upregulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, PTX3 is prepared by recombinant techniques. In some embodiments, PTX3 is expressed from a recombinant expression vector. In some embodiments, the nucleic acid encoding PTX3 is operably linked to a constitutive promoter. In some embodiments, the nucleic acid encoding PTX3 is operably linked to an inducible promoter. In some embodiments, PTX3 is expressed in the transgenic animal. In some embodiments, PTX3 is a recombinant protein. In some embodiments, PTX3 is a recombinant protein isolated from cells. In some embodiments, PTX3 is a recombinant protein produced in a cell free extract.

  In some embodiments, PTX3 is purified from amniotic membrane, umbilical cord, umbilical cord amniotic membrane, chorion, amniotic fluid, or combinations thereof. In some embodiments, PTX3 is purified from amniotic cells. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, amniotic cells are stimulated with more inflammatory cytokines to upregulate PTX3 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, PTX3 is not isolated from cells or multiple cells (eg, tissue extracts).

  In some embodiments, PTX3 is at least 65%, 70% to a polypeptide having a sequence specified by SEQ ID NO: 33 or a polypeptide having a sequence specified by SEQ ID NO: 33 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity thereof. Exemplary variants include, for example, species variants, allelic variants, and variants including conservative and non-conservative amino acid variations. In some embodiments, PTX3 comprises sufficient fragments of PTX3 to bind to HA and promote the formation of the rcHC-HA / PTX3 complex. In some embodiments, PTX3 comprises Glu18 to Ser277 of human PTX3. Variants of PTX3 used in the provided methods include variants that contain amino acid modifications that are amino acid substitutions (substitutions), deletions, or insertions. In some embodiments, such modifications are one or more therapeutic properties of the rcHC-HA / PTX3 complex (eg, anti-inflammatory, anti-immune, anti-angiogenic, anti-scarring, anti-adhesion, regeneration, or Improve one or more properties of the PTX3 polypeptide, such as improving other therapeutic activities as described herein.

  In some embodiments, the PTX3 protein is obtained from a commercial source. A typical commercial source for PTX3 is, but is not limited to, PTX3 (Catalog No. 1826-TS; R & D Systems, Minneapolis, MN).

  In some embodiments, the PTX3 protein used in the method is a multimeric protein. In some embodiments, the PTX3 protein used in the method is a homomultimer. In some embodiments, the homomultimer is a dimer, trimer, tetramer, hexamer, pentamer, or octamer. In some embodiments, the PTX3 homomultimer is a trimer, tetramer, or octamer. In certain embodiments, the PTX3 homomultimer is an octamer. In some embodiments, the multimerization domain is modified to improve multimerization of the PTX3 protein. In some embodiments, the multimerization domain is replaced with a heterologous multimerization domain (eg, an Fc multimerization domain or a leucine zipper) that, when fused to PTX3, improves PTX3 multimerization.

  TSG-6

  In some embodiments, TSG-6 used in the method is isolated from a cell or a plurality of cells (eg, a tissue extract). Typical cells suitable for expression of TSG-6 include, but are not limited to, animal cells (including but not limited to mammalian cells, primate cells, human cells, rodent cells, insect cells, Bacteria and yeast) and plant cells (including but not limited to algae, angiosperms, gymnosperms, ferns and moss plants). In some embodiments, TSG-6 used in the method is isolated from human cells. In some embodiments, TSG-6 used in the method is isolated from cells stimulated with one or more inflammatory cytokines to upregulate TSG-6 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 used in the method is isolated from amniotic cells. In some embodiments, TSG-6 used in the method is isolated from amniotic cells from the umbilical cord. In some embodiments, TSG-6 used in the method is separated from amniotic cells stimulated with one or more inflammatory cytokines to upregulate TSG-6 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 used in the method is isolated from umbilical cord cells. In some embodiments, TSG-6 used in the method is isolated from umbilical cord cells stimulated with one or more inflammatory cytokines to upregulate TSG-6 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 used in the method is isolated from epithelial cells of amniotic membrane. In some embodiments, TSG-6 used in the method is isolated from umbilical cord epithelial cells. In some embodiments, the TSG-6 used in the method is an amnion epithelial cell or umbilical cord epithelial cell stimulated with one or more inflammatory cytokines to upregulate TSG-6 expression Isolated from In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 used in the method is isolated from amnion stromal cells. In some embodiments, TSG-6 used in the method is isolated from umbilical cord stromal cells. In some embodiments, the TSG-6 used in the method is between amnion stromal cells or umbilical cord stimulated with one or more inflammatory cytokines to upregulate TSG-6 expression Isolated from stromal cells. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, the TSG-6 used in the method is a native TSG-6 protein isolated from cells. In some embodiments, the cells are stimulated with more inflammatory cytokines to upregulate TSG-6 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 is prepared by recombinant techniques. In some embodiments, TSG-6 is expressed from a recombinant expression vector. In some embodiments, the nucleic acid encoding TSG-6 is operably linked to a constitutive promoter. In some embodiments, the nucleic acid encoding TSG-6 is operably linked to an inducible promoter. In some embodiments, TSG-6 is expressed in the transgenic animal. In some embodiments, TSG-6 is a recombinant protein. In some embodiments, TSG-6 is a recombinant protein isolated from cells. In some embodiments, TSG-6 is a recombinant protein produced in a cell free extract.

  In some embodiments, TSG-6 is purified from amniotic membrane, amniotic membrane, chorion, amniotic fluid, or a combination thereof. In some embodiments, PTX3 is purified from amniotic cells. In some embodiments, the amniotic cell is an amniotic epithelial cell. In some embodiments, the amniotic epithelial cells are umbilical cord epithelial cells. In some embodiments, the amniotic cell is an amniotic stromal cell. In some embodiments, the amniotic cells are umbilical cord stromal cells. In some embodiments, amniotic cells are stimulated with more inflammatory cytokines to upregulate TSG-6 expression. In some embodiments, the inflammatory cytokine is IL-1 or TNF-α.

  In some embodiments, TSG-6 is not isolated from cells or multiple cells (eg, tissue extracts).

  In some embodiments, TSG-6 comprises a fragment of TSG-6 sufficient to promote or catalyze IαI HC1 transduction to HA. In some embodiments, TSG-6 includes a link module of TSG-6. In some embodiments, TSG-6 comprises amino acid Trp18 by Leu277 of TSG-6. In some embodiments, TSG-6 is at least 65% relative to a polypeptide having a sequence specified by SEQ ID NO: 2, or a polypeptide having a sequence specified by SEQ ID NO: 2. Including variants thereof having 70%, 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. Exemplary variants include, for example, species variants, allelic variants, and variants including conservative and non-conservative amino acid variations. Natural allelic variants of human TSG-6 include, for example, TSG-6 which includes the amino acid substitution Q144R. Variants of TSG-6 or HA that bind fragments used in the provided methods include variants that contain amino acid modifications that are amino acid substitutions (substitutions), deletions, or insertions. In some embodiments, such modifications improve one or more properties of the TSG-6 polypeptide (eg, after improved transmission of IαI HC1 to HA or after transmission of IαI HC1 to HA. Improved release of TSG-6 polypeptide from rcHC-HA / PTX3).

  In some embodiments, TSG-6 includes an affinity tag. Typical affinity tags include, but are not limited to, hemagglutinin tags, poly-histidine tags, myc tags, FLAG tags, glutathione-S-transferase (GST) tags. Such affinity tags are well known in the art used in purification. In some embodiments, such affinity tags are incorporated into TSG-6 polypeptides as fusion proteins or by chemical linkers. In some embodiments, TSG-6 contains an affinity tag and unbound TSG-6 is removed from the rcHC-HA / PTX3 complex by affinity purification.

  In some embodiments, the TSG-6 protein is obtained from a commercial source. A typical commercial source for TSG-6 is, but not limited to, TSG-6 (Catalog No. 2104-TS R & D Systems, Minneapolis, MN).

  IαI

  In some embodiments, IαI comprises an HC1 chain. In some embodiments, IαI comprises HC1 and HC2 chains. In some embodiments, IαI comprises HC1 and bikunin. In some embodiments, IαI comprises HC1 and HC2 chains and bikunin. In some embodiments, IαI comprises HC1 and HC2 chains and bikunin linked by chondroitin sulfate chains.

  In some embodiments, IαI is isolated from a biological sample. In some embodiments, the biological sample is a biological sample from a mammal. In some embodiments, the mammal is a human. In one embodiment, the biological sample is a sample of blood, serum, plasma, liver, amniotic membrane, chorion, or amniotic fluid. In some embodiments, the biological sample is a blood, serum, or plasma sample. In some embodiments, the biological sample is a blood sample. In some embodiments, the biological sample is a serum sample. In some embodiments, the biological sample is a plasma sample. In some embodiments, IαI is purified from human blood, plasma, or serum. In some embodiments, IαI is isolated from human serum. In some embodiments, IαI is not isolated from serum. In some embodiments, IαI used in the method is produced in amniotic cells. In some embodiments, IαI used in the method is produced in cells of the umbilical cord. In some embodiments, IαI used in the method is produced in amniotic cells from the umbilical cord. In some embodiments, IαI used in the method is produced in epithelial cells of amniotic membrane. In some embodiments, IαI used in the method is produced in umbilical cord epithelial cells. In some embodiments, IαI used in the method is produced in amnion stromal cells. In some embodiments, IαI used in the method is produced in umbilical cord stromal cells. In some embodiments, IαI used in the method is produced in hepatocytes. In some embodiments, IαI is prepared by recombinant techniques.

  In some embodiments, IαI HC1 is isolated from a biological sample. In some embodiments, the biological sample is a biological sample from a mammal. In some embodiments, the mammal is a human. In some embodiments, the biological sample is a sample of blood, serum, plasma, liver, amniotic membrane, chorion, or amniotic fluid. In some embodiments, the biological sample is a blood, serum, or plasma sample. In some embodiments, the biological sample is a blood sample. In some embodiments, the biological sample is a serum sample. In some embodiments, the biological sample is a plasma sample. In some embodiments, IαI HC1 is purified from human blood, plasma, or serum. In some embodiments, IαI is isolated from human serum. In some embodiments, IαI HC1 is not purified from serum. In some embodiments, IαI HC1 is prepared by recombinant techniques. In some embodiments, IαI HC1 is purified from hepatocytes. In some embodiments, IαI HC1 is purified from amniotic cells. In some embodiments, IαI HC1 is purified from amniotic epithelial cells or umbilical cord epithelial cells. In some embodiments, IαI HC1 is purified from amniotic stromal cells or umbilical cord stromal cells.

  In some embodiments, HC1 is at least 75%, 80% relative to a polypeptide having the sequence specified by SEQ ID NO: 47 or a polypeptide having the sequence specified by SEQ ID NO: 47. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity.

  In some embodiments, IαI HC2 is isolated from a biological sample. In some embodiments, the biological sample is a biological sample from a mammal. In some embodiments, the mammal is a human. In some embodiments, the biological sample is a blood, serum, plasma, liver, amniotic membrane, chorion, or amniotic fluid sample. In some embodiments, the biological sample is a blood, serum, or plasma sample. In some embodiments, the biological sample is a blood sample. In some embodiments, the biological sample is a serum sample. In some embodiments, the biological sample is a plasma sample. In some embodiments, IαI HC2 is purified from human blood, plasma, or serum. In some embodiments, IαI HC2 is isolated from human serum. In some embodiments, IαI HC2 is isolated from human serum. In some embodiments, IαI HC2 is not isolated from serum. In some embodiments, IαI HC2 is prepared by recombinant techniques. In some embodiments, IαI HC2 is purified from hepatocytes. In some embodiments, IαI HC2 is purified from amniotic cells. In some embodiments, IαI HC2 is purified from amniotic epithelial cells or umbilical cord epithelial cells. In some embodiments, IαI HC2 is purified from amniotic stromal cells or umbilical cord stromal cells.

  In some embodiments, HC2 is at least 75%, 80% relative to a polypeptide having a sequence specified by SEQ ID NO: 49, or a polypeptide having a sequence specified by SEQ ID NO: 49. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity.

  In some embodiments, IαI comprises bikunin. In some embodiments, bikunin is at least 75%, 80% relative to a polypeptide having a sequence specified as SEQ ID NO: 53, or a polypeptide having a sequence specified as SEQ ID NO: 53. , 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity. In some embodiments, IαI comprises a chondroitin sulfate chain.

  HA

  In some embodiments, the HA is purified from a cell, tissue, or fluid sample. In some embodiments, the HA is obtained from commercial sources (eg, Sigma Aldrich or Advanced Medical Optics, Irvine, Calif. (Eg, Healon)). In some embodiments, the HA is obtained as a powder from a commercial source. In some embodiments, HA is expressed in the cell. Typical cells suitable for HA expression include, but are not limited to, animal cells (including but not limited to mammalian cells, primate cells, human cells, rodent cells, insect cells, bacteria, And yeast cells) and plant cells (including but not limited to algae, angiosperms, gymnosperms, ferns and moss plants). In some embodiments, HA is expressed in human cells. In some embodiments, HA is expressed in transgenic animals. In some embodiments, the HA is obtained from cells that express hyaluronan synthase (eg, HAS1, HAS2, and HAS3). In some embodiments, the cell includes a recombinant expression vector that expresses HA synthase. In certain instances, HA synthase extends hyaluronan by repeatedly adding glucuronic acid and N-acetylglucosamine to the nascent polysaccharide as it is extruded through the cell membrane into the extracellular space.

  The HA used in the process is typically high molecular weight (HMW) HA. In some embodiments, the weight average molecular weight of the HMW HA is greater than about 500 kilodaltons (kDa), such as between about 500 kDa and about 10,000 kDa, between about 800 kDa and about 8,500 kDa, about 1100 kDa. And about 5,000 kDa, or between about 1400 kDa and about 3,500 kDa. In some embodiments, the weight average molecular weight of HMW HA is about 3000 kDa.

  Additional ingredients

  In some embodiments, one or more additional components are added to produce the rcHC-HA / PTX3 complex. In some embodiments, small leucine-rich proteoglycan (SLRP) is added to generate the rcHC-HA / PTX3 complex. In some embodiments, the SLRP is a Type I, Type II, or Type III SLRP. In some embodiments, the SLRP is selected from among type I SLRPs such as decorin and biglycan. In some embodiments, the SLRP is selected from among type II SLRPs such as fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, and osteoadherin. . In some embodiments, the SLRP is selected from among type III SLRPs such as epipican and osteoglycine. In some embodiments, the SLRP is selected from among bikunin, decorin, biglycan, and osteoadherin. In some embodiments, the SLRP comprises a glycosaminoglycan. In some embodiments, the SLRP comprises keratan sulfate.

  HA immobilization

  In some embodiments, the HMW HA is immobilized by any suitable method. In some embodiments, the HMW HA is on a solid support, such as a culture dish, bead, column, or other suitable surface such as the surface of an implantable medical device or part thereof, or the book Immobilized on a surface that is substantially associated or combined with an implantable medical device as described herein. In some embodiments, the HMW HA is fixed directly to the solid support, such as by chemical bonding. In some embodiments, the HMW HA is indirectly attached to the solid support by a linker or intermediate protein. Many heterobifunctional cross-linking reagents used to form covalent bonds between amino and thiol groups and to introduce thiol groups into proteins are known to those skilled in the art. In some embodiments, the HMW HA is fixed directly to the solid support by crosslinking to the solid support. In some embodiments, the HMW HA is fixed directly to the solid support without cross-linking to the solid support. In some embodiments, the HMW HA is fixed directly to a solid support as a coating agent. In some embodiments, the HMW HA is immobilized on a Covalink ™ -NH surface. In some embodiments, the HMW HA is fixed directly to a solid support as a coating agent. In some embodiments, the HMW HA is immobilized on the Covalink ™ -NH surface for about 16 hours at 4 ° C.

  In some embodiments, the method comprises immobilizing HMW HA to a solid surface by direct binding to a solid support (ie, without an intermediate protein). In some embodiments, the solid support is washed to remove unbound HMW HA prior to contacting the immobilized HA with PTX3. In some embodiments, prior to contacting the immobilized HA with PTX3, the solid support is washed with 8 M GnHCl and PBS wash to remove unbound HMW HA.

  In some embodiments, the method comprises immobilizing HA on a solid surface with an intermediate protein or linker. In some embodiments, the linker is a peptide linker. In some embodiments, the intermediate protein is an HA binding protein (HABP). In some embodiments, the HABP is first bound to a solid support (eg, by cross-linking, chemical bonding, or a chemical linker). In some embodiments, the solid support comprising HABP is then contacted with HA (eg, HMW HA) to immobilize HA on the solid support by binding of HABP to HA. In some embodiments, the solid support is washed to remove unbound HMW HA prior to contacting the immobilized HMW HA with PTX3. In some embodiments, prior to contacting the immobilized HA with PTX3, the solid support is washed with 8 M GnHCl and PBS wash to remove unbound HMW HA.

  In some embodiments, the method comprises immobilizing HA on a solid surface by binding a peptide linker to a solid support and binding HA to the peptide linker. In some embodiments, the peptide linker comprises a protease cleavage site.

  In some embodiments, the method includes immobilizing HA on a solid surface by attachment of a cleavable chemical linker such as, but not limited to, a disulfide chemical linker.

  In some embodiments, the HABP chosen for use in the method is a HABP that is dissociated from the HA after formation of the rcHC-HA / PTX3 complex. In some embodiments, HABP binds HA non-specifically. In some embodiments, the method further comprises dissociating the rcHC-HA / PTX3 complex from HABP using one or more dissociating agents. Dissociating agents (eg, guanidine hydrochloride, urea, and various detergents (eg, SDS)) for breaking non-covalent interactions are known in the art. In some embodiments, the dissociator is urea. In some embodiments, the dissociator is guanidine hydrochloride. In some embodiments, the dissociator is about 4M to about 8M guanidine-HCl. In some embodiments, the dissociator is about 4M, about 5M, about 6M, about 7M, about 8M guanidine-HCl. In some embodiments, the dissociator is about 4 M to about 8 M guanidine-HCl in PBS pH 7.5.

  In some embodiments, such dissociating agents are employed to dissociate the rcHC-HA / PTX3 complex from the intermediate HABP. The HABP used in the method is typically strong enough that the binding affinity of the HA allows assembly of the rcHC-HA / PTX3 complex, but the rcHC-HA containing a suitable dissociator Is selected to be separated from the / PTX3 complex. In some embodiments, the dissociator is guanidine hydrochloride.

  Exemplary HABPs used with the methods provided herein include, but are not limited to, HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, brevican, phosphacan, TSG-6, CD44, stabilin- 1, stabilin-2, or a portion thereof sufficient to bind HA (eg, these link modules). In some embodiments, the HABP is a polypeptide having a sequence specified by any of SEQ ID NOS: 54-99, or a poly having a sequence specified by any of SEQ ID NOS: 54-99. Polypeptides having at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity to the peptide are included. In some embodiments, the HABP is versican. In some embodiments, HABP is a recombinant protein. In some embodiments, the HABP is a recombinant mammalian protein. In some embodiments, the HABP is a recombinant human protein. In some embodiments, the HABP is a recombinant versican protein, or a portion thereof sufficient to bind to HA. In some embodiments, the HABP is a recombinant aggrecan protein or a portion thereof sufficient to bind to HA. In some embodiments, the HABP is native HABP or a portion thereof sufficient to bind to HA. In some embodiments, native HABP is isolated from mammalian tissue or cells. In some embodiments, HABP is isolated from bovine nasal cartilage (eg, HABP from Seikagaku, which contains the HA binding region of aggrecan and link protein).

  In some embodiments, the HABP comprises a HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, blebican, phosphacan, TSG-6, CD44, stabilin-1 or stabilin-2 link module. In some embodiments, the HABP comprising the link module is a polypeptide having a sequence specified in any of the binding domains of SEQ ID NOS: 54-99, or of the binding domain of SEQ ID NOS: 54-99. Have at least 75%, 80%, 85%, 90%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity to a polypeptide having the sequence specified in any A polypeptide. In some embodiments, the HABP includes a Versican link module. In some embodiments, the HABP that includes the link module is a recombinant protein. In some embodiments, the HABP comprising a versican link module is a recombinant protein.

  In some embodiments, an intermediate protein such as HABP is recognized and hydrolyzed by a site-specific protease such as furin, 3C protease, caspase, matrix metalloprotease, or TEV protease. Includes sequences. In such embodiments, the assembled rcHC-HA / PTX3 complex is released from the solid support by contacting the immobilized complex with a protease that cleaves a specific cleavage sequence.

  In some embodiments, the rcHC-HA / PTX3 complex is purified. In some embodiments, the rcHC-HA / PTX3 complex is purified by any suitable method or combination of methods. The embodiments described below are not intended to be exclusive, but are exemplary only.

  In some embodiments, the rcHC-HA / PTX3 complex is chromatographed (eg, ion exchange, affinity, size exclusion, and hydroxyapatite chromatography), gel filtration, centrifugation (eg, gradient centrifugation). ) Or by differential solubility, ethanol precipitation, or other available techniques for protein purification.

  In some embodiments, the rcHC-HA / PTX3 complex is purified by immunoaffinity chromatography. In some embodiments, antibodies are raised against components of the rcHC-HA / PTX3 complex (eg, antibodies against one or more SLRPs of the anti-HC1, anti-PTX, rcHC-HA / PTX3 complex, such as , Anti-bikunin, anti-decorin, anti-biglycan, or anti-osteoadherin) attached to a solid support. In some embodiments, the unpurified rcHC-HA / PTX3 complex (ie, mobile phase) passes over the support. In a particular example, the rcHC-HA / PTX3 complex binds to the antibody. In some embodiments, the support is washed (eg, with PBS) to remove any unbound or loosely bound molecules. In some embodiments, the support is washed with a solution that allows elution of the rcHC-HA / PTX3 complex from the support (eg, 1% SDS, 6M guanidine-HCl, or 8M Of urea). In some embodiments, the dissociator is removed from the dissociated rcHC-HA / PTX3 complex. In some embodiments, the dissociating agent is dissociated rcHC-HA / PTX3 complex by methods including but not limited to ion exchange chromatography, dialysis, gel filtration chromatography, ultrafiltration, or diafiltration. Removed from the body.

  In some embodiments, the rcHC-HA / PTX3 complex is purified by affinity chromatography. In some embodiments, HABP is employed to bind to the rcHC-HA / PTX3 complex and is affixed to a stationary support to purify the complex. In some embodiments, the unpurified rcHC-HA / PTX3 complex (ie, mobile phase) passes over the support. In a particular example, the rcHC-HA / PTX3 complex binds to HABP. In some embodiments, the support is washed (eg, with PBS) to remove any unbound or loosely bound molecules. In some embodiments, the support is then washed with a solution (eg, a dissociator) that allows elution of the rcHC-HA / PTX3 complex from the support. In some embodiments, the dissociator is a rcHC-HA / PTX3 complex dissociated by methods including, but not limited to, ion exchange chromatography, separation, gel filtration chromatography, ultrafiltration or diafiltration. Removed from.

  In some embodiments, the rcHC-HA / PTX3 complex is obtained by a combination of HABP affinity chromatography and immunoaffinity chromatography using antibodies against one or more components of the rcHC-HA / PTX3 complex. Purified.

  In some embodiments, one or more components of the rcHC-HA / PTX3 complex disclosed herein comprise an affinity tag (eg, a PTX3 or HC1 fusion protein comprising an affinity tag). Exemplary affinity tags incorporated in one or more components of the rcHC-HA / PTX3 complex in some embodiments include, but are not limited to, hemagglutinin tag, polyhistidine, myc tag, FLAG tag, or glutathione- Contains the S-transferase sequence. In some embodiments, the affinity tag ligand binds to a solid support. In some embodiments, the crude rcHC-HA / PTX3 complex passes over the support. In a particular example, the rcHC-HA / PTX3 complex binds to a ligand. In some embodiments, the support is washed (eg, with PBS) to remove any unbound or loosely bound molecules. In some embodiments, the support is washed with a solution that allows elution of the rcHC-HA / PTX3 complex disclosed herein from the support. In some embodiments, the eluent is isolated from the dissociated rcHC-HA / PTX3 complex by methods including, but not limited to, ion exchange chromatography, separation, gel filtration chromatography, ultrafiltration or diafiltration. Removed.

  In some embodiments, PTX3, TSG-6, and / or HC1 is conjugated to a label. “Label” refers to a detectable compound or composition that is directly or indirectly conjugated to a polypeptide to produce a labeled polypeptide. In some embodiments, the label is detectable by itself (eg, a radioisotope label or fluorescent label) or, in the case of an enzyme label, catalyzes a chemical change in the detectable substrate compound composition. To do. Non-limiting examples of labels include fluorogenic moieties, dyes, fluorescent tags, green fluorescent protein, or luciferase.

(Method for evaluating the activity of a complex of nHC-HA / PTX3 and rcHC-HA / PTX3)

  The properties of the nHC-HA / PTX3 and rcHC-HA / PTX3 complexes provided herein are evaluated by any suitable method, including in vitro and in vivo methods. Exemplary in vitro methods are provided herein, including, but not limited to, macrophage binding to promote macrophage binding to immobilized nHC-HA / PTX3 or rcHC-HA / PTX3 complexes. NHC-HA / PTX3 or rcHC- to promote apoptosis of neutrophils, macrophage phagocytosis of apoptotic neutrophils, and M2 polarization of stimulated macrophages to inhibit or reduce aggregation A cell culture method for assessing the ability of the HA / PTX3 complex is included. In some embodiments, the macrophages used in the assay are stimulated, such as by exposure to LPS or IFN-γ. In some embodiments, the expression of a gene or protein in stimulated macrophages is assessed after contact with the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In such methods of assessing the activity of nHC-HA / PTX3 or rcHC-HA / PTX3 complexes, appropriate controls are used for comparison. In some embodiments, the control lacks treatment with a nHC-HA / PTX3 or rcHC-HA / PTX3 complex (ie, a negative control).

  In some embodiments, the activity of the rcHC-HA / PTX3 complex is compared to the activity of the native HC-HA / PTX3 complex. In some embodiments, native HC-HA / PTX3 is isolated from amniotic membrane.

  In some embodiments, gene expression in the treated macrophages is detected by PCR, RT PCR, Northern blot, Western blot, dot blot, immunohistochemistry, chromatography, or protein or nucleic acid To be evaluated by other appropriate methods. In some embodiments, the level of expression of IL-10, IL-12, IL23, LIGHT, and SPHK1 is assessed.

  Exemplary in vitro methods for assessing the activity of the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein include, but are not limited to, animal models of various diseases and conditions. Various animal models include but are not limited to ischemia, reperfusion injury, type 1 and type 2 diabetes, inflammatory diseases, collagen-induced arthritis, rheumatoid arthritis, collagen-induced arthritis and myelin peptide-induced experimental allergies Antigen-induced autoimmune diseases such as encephalomyelitis, inflammatory bowel disease (IBD) / ulcerative colitis, multiple sclerosis, surgery-induced osteoarthritis and nephritis, psoriasis, inflammatory skin diseases, Various inflammatory diseases, including LPS-induced endotoxin shock, LPS-induced lung injury, allergic rhinitis, liver injury, chronic stress, asthma, and various cancer xenograft and allograft models It is available and well known in the disease and disease art, including animal models of autoimmune diseases (eg, rodent and primate models).

  In some embodiments, the animal model is a rodent model of inflammation such as chronic graft versus host disease (cGVHD), HSV1-induced necrotizing interstitial keratitis, or high-risk corneal transplantation. is there. In some embodiments, the reduction in inflammation due to treatment with nHC-HA / PTX3 or rcHC-HA / PTX3 results in T cell proliferation and activation, as well as IL-1α, IL-2, IL-6, IFN- It is evaluated by measuring the production of immune cytokines such as γ and TNF-α. In some embodiments, the animal model is a scar of a rodent model, such as excimer laser assisted laser refractive keratotomy (PRK). Exemplary methods used for such animal models are provided in the examples provided herein.

  In some embodiments, the animal model is a genetic model of inflammatory and autoimmune diseases and disorders, which includes one or more genetic changes that cause the disease or disorder. In some embodiments, such models are obtained from commercial sources. In some embodiments, a nHC-HA / PTX3 or rcHC-HA / PTX3 complex provided herein is administered to an animal model of a particular disease or condition, and one or more of the disease or condition The ability of the rcHC-HA / PTX3 complex to inhibit or reduce the symptoms of is assessed.

(Pharmaceutical composition)
In certain embodiments, disclosed herein are pharmaceutical compositions comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes described herein. In certain embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced by the methods provided herein is disclosed herein. In some embodiments, the pharmaceutical composition comprises excipients and auxiliaries that facilitate the processing of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex into a preparation suitable for pharmaceutical use. It is formulated in a conventional manner using one or more physiologically acceptable carriers. Proper formulation is dependent upon the route of administration chosen. Any of the repair techniques, carriers, and excipients can be used as appropriately understood in the art.

  In certain embodiments, disclosed herein are pharmaceutical compositions comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein. In some embodiments, the pharmaceutical composition further comprises at least one pharmaceutically acceptable carrier. In some embodiments, the pharmaceutical composition further comprises an adjuvant, excipient, preservative, agent that delays absorption, filler, binder, adsorbent, buffer, and / or solubilizer. Exemplary pharmaceutical compositions formulated to include the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein include, but are not limited to, solutions, suspensions, emulsions, syrups. , Granule, powder, ointment, tablet, capsule, pill, or aerosol.

  Dosage form

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered as an aqueous suspension. In some embodiments, the aqueous suspension comprises water, Ringer's solution, and / or saline. In some embodiments, the aqueous suspension comprises a sweetener or flavoring agent, a colorant or pigment, and optionally a diluent, water, ethanol, propylene glycol, glycerin, or combinations thereof. Together, an emulsifier or suspending agent is included. In some embodiments, the aqueous suspension includes a suspending agent. In some embodiments, the aqueous suspension comprises sodium carboxymethyl cellulose, methyl cellulose, hydroxypropyl methyl cellulose, sodium alginate, polyvinyl pyrrolidone, gum tragacanth, and / or gum arabic. In some embodiments, the aqueous suspension includes a dispersing or wetting agent. In some embodiments, the aqueous suspension comprises a natural phospholipid, such as lecithin, or a condensate of an alkylene oxide that includes a fatty acid, such as polyoxyethylene stearate, or a long chain aliphatic alcohol. Condensates of ethylene oxide, for example, heptadecaethylene-oxycetanol, or ethylene oxide condensates containing fatty acid-derived and hexitol-derived partial esters such as polyoxyethylene sorbitol monocreate, or derived from fatty acids And ethylene oxide condensates containing partial esters derived from hexitol anhydrides such as, for example, polyethylene sorbitan monocreate. In some embodiments, the aqueous suspension includes a preservative. In some embodiments, the aqueous suspension comprises ethyl or propyl n-paraoxybenzoate. In some embodiments, the aqueous suspension includes a sweetening agent. In some embodiments, the aqueous suspension comprises sucrose, saccharin, or aspartame.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered as an oily suspension. In some embodiments, oily suspensions are formulated by suspending the active ingredient in vegetable oil (eg, peanut oil, olive oil, sesame oil, or coconut oil) or in mineral oil (eg, liquid paraffin). Is done. In some embodiments, the oily suspension includes a thickening agent (eg, beeswax, hard paraffin, or cetyl alcohol). In some embodiments, the oily suspension includes a sweetener (eg, as specified above). In some embodiments, the oily suspension includes an antioxidant (eg, butylhydroxyanisole or alpha tocopherol).

  In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered parenterally (eg, intraarterial, intracardiac, intradermal, duodenum, intramedullary For intramuscular, intraosseous, intraperitoneal, intrathecal, intravascular, intravenous, intravitreal, epidural and / or subcutaneous injection or infusion). In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered as a sterile solution, suspension, or emulsion.

  In some embodiments, formulations for parenteral administration may be made isotonic with the blood of the intended recipient, depending on the embodiment, antioxidants, buffers, bacteriostats, and / or formulations. An aqueous and / or non-aqueous (oil-based) sterile infusion solution of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein, and / or an embodiment comprising Some include aqueous and / or non-aqueous sterile suspensions containing suspending agents and / or thickeners. In some embodiments, formulations for parenteral administration increase the solubility of the rcHC-HA / PTX3 complex disclosed herein to allow for the preparation of high concentration solutions. Contains stabilizers or drugs.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered as an oil-in-water microemulsion in which the active ingredient is dissolved in the oil phase. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is a fatty oil (eg, sesame oil or a synthetic fatty acid ester (eg, ethyl oleate or triglyceride, Or in some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is dissolved in a mixture of soybean oil and / or lecithin. In some embodiments, the oil is placed in a mixture of water and glycerol and when processed, a microemulsion is formed.

  In some embodiments, a composition formulated for parenteral administration is administered as a single bolus shot. In some embodiments, the composition formulated for parenteral administration is administered by a continuous intravenous delivery device (eg, Deltec CADD-PLUS ™ model 5400 intravenous pump).

  In some embodiments, injectable formulations are presented in unit dosage forms, eg, ampoules or multiple dose containers containing additional preservatives. In some embodiments, the infused formulation requires only the addition of a sterile liquid carrier, such as saline or sterile pyrogen-free water, just prior to use, in powder form, or Stored in freeze-dried (freeze-dried) state.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated for topical administration. Topical formulations include, but are not limited to, ointments, creams, lotions, solutions, pastes, gels, films, sticks, liposomes, nanoparticles. In some embodiments, the topical formulation is administered using a patch, bandage, or wound dressing.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated as a composition in the form of a solid, cross-linked gel, or liposome. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated as insoluble cross-linked hydrogels.

  In some embodiments, the topical formulation includes a gelling (or thickening) agent. Suitable gelling agents include, but are not limited to, cellulose, cellulose derivatives, cellulose ethers (eg, carboxymethylcellulose, ethylcellulose, hydroxyethylcellulose, hydroxymethylcellulose, hydroxypropylmethylcellulose, hydroxypropylcellulose, methylcellulose), guar gum, xanthan gum, locust Bean gum, alginate (eg, alginic acid), silicate, starch, tragacanth, carboxyvinyl polymer, carrageenan, paraffin, petrolatum, acacia (gum arabic), agar, magnesium aluminum silicate, sodium alginate, sodium stearate, hibamata (Bladdertrack), bentonite, carbomer, carrageenan, carbo Carbol, xanthan, cellulose, microcrystalline cellulose (MCC), seratonia, genus genus, dextrose, furcellaran, gelatin, ghatti gum, guar gum, hectorite, lactose, sucrose , Maltodextrin, mannitol, sorbitol, honey, corn starch, wheat starch, rice starch, potato starch, gelatin, sterulia gum, polyethylene glycol (eg PEG 200-4500), tragacanth gum, ethyl cellulose, ethyl hydroxyethyl cellulose , Ethylmethylcellulose, methylcellulose, hydroxyethylcellulose, hydroxyethyl Methyl cellulose, hydroxypropyl cellulose, poly (hydroxyethyl methacrylate), oxypolygelatin, pectin, polygelin, povidone, propylene carbonate, methyl vinyl ether / maleic anhydride copolymer (PVM / MA), poly (methoxyethyl methacrylate), poly (methoxyethoxy) Ethyl methacrylate), hydroxypropylcellulose, hydroxypropylmethylcellulose (HPMC), sodium carboxymethylcellulose (CMC), silicon dioxide, polyvinylpyrrolidone (PVP: povidone), or combinations thereof.

  In some embodiments, the topical formulations disclosed herein comprise an emollient. Emollients include, but are not limited to, castor oil ester cocoa butter ester, safflower oil ester, cottonseed oil ester, corn oil ester, olive oil ester, cod liver oil ester, almond oil ester, avocado oil ester, palm oil ester, sesame oil ester Squalene ester, kikui oil ester, soybean oil ester, acetylated monoglyceride, ethoxylated glyceryl monostearate, hexyl laurate, isohexyl laurate, isohexyl palmitate, isopropyl palmitate, methyl palmitate, decyl oleate (Decyloleate), isodecyl oleate, hexadecyl stearate, decyl stearate, isopropyl isostearate, isostearyl Methyl acid, diisopropyl adipate, diisohexyl adipate, dihexyl decyl adipate, diisopropyl sebacate, lauryl lactate, myristyl lactate, and cetyl lactate, oleyl myristate, oleyl stearate and oleate, pelargonic acid, lauric acid, myristic Acid, palmitic acid, stearic acid, isostearic acid, hydroxystearic acid, oleic acid, linoleic acid, ricinoleic acid, arachidic acid, behenic acid, erucic acid, lauryl alcohol, myristyl alcohol, cetyl alcohol, hexadecyl alcohol, stearyl alcohol, iso Stearyl alcohol, hydroxystearyl alcohol, oleyl alcohol, ricinoleyl alcohol, behen (behen) yl) alcohol, erucyl alcohol, 2-octyldodecanyl alcohol, lanolin and lanolin derivatives, beeswax, spermaceti, myristyl myristate, stearyl stearate, carnauba wax, candelilla wax, lecithin, and cholesterol Can be mentioned.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated with one or more natural polymers. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are fibronectin, collagen, laminin, keratin, fibrin, fibrinogen, hyaluronic acid, heparan sulfate, chondroitin sulfate. Is formulated with a natural polymer. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is formulated in a polymer gel formulated from a natural polymer. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein include, but are not limited to, fibronectin, collagen, laminin, keratin, fibrin, fibrinogen, hyaluronic acid, heparan Formulated with polymer gels formulated from natural polymers such as sulfuric acid, chondroitin sulfate, and combinations thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated with a crosslinked polymer. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is formulated with a non-crosslinked polymer. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is formulated with a non-crosslinked polymer and a crosslinked polymer. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is formulated with a crosslinked hyaluronan gel. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is formulated with an insoluble cross-linked HA hydrogel. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated in a non-crosslinked hyaluronan gel. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated in a collagen matrix. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated with a fibrin matrix. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated in a fibrin / collagen matrix.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated for administration to the eye or tissue associated therewith. Formulations suitable for administration to the eye include, but are not limited to, solutions, suspensions (eg, aqueous suspensions), ointments, gels, creams, liposomes, niosomes, pharmacosomes. ), Nanoparticles, or a combination thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein for topical administration to the eye is administered by spraying, washing, or a combination thereof. . In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to the eye by an injectable devo formulation.

  As used herein, a “devo formulation” is implanted in the eye or related tissue (eg, sclera) (eg, subcutaneously, intramuscularly, intravitreally, or subconjunctivally). Controlled release formulation. In some embodiments, the devoted formulation is a biodegradable polymer, a microencapsulated matrix (microencapsulated matrix) of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. Is also formulated by forming. In some embodiments, the devoted formulation is formulated in a liposome or microemulsion by capturing the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein.

  Formulations administered to the eye have tonicity acceptable to the eye. In a particular example, the tear fluid has an isotonic value equivalent to 0.9% sodium chloride solution. In some embodiments, an isotonic value from about 0.6% to about 1.8% sodium chloride equivalent is suitable for topical administration to the eye. In some embodiments, the formulations administered to the eye disclosed herein have an osmolarity of about 200 to about 600 mOsm / L. In some embodiments, the formulations administered in the eye disclosed herein are hypotonic and therefore require appropriate additions to reach the proper tonicity range. Substances acceptable to the eye that modulate tonicity include, but are not limited to, sodium chloride, potassium chloride, sodium thiosulfate, sodium sulfite, and ammonium sulfate.

  Formulations administered to the eye have transparency that is acceptable to the eye. Examples of clarifying agents that are acceptable to the eye include, but are not limited to, polysorbate 20, polysorbate 80, or a combination thereof.

  In some embodiments, the formulation administered to the eye includes an eye acceptable viscosity enhancer. In some embodiments, the viscosity enhancer increases the time that the formulations disclosed herein are noticeable. In some embodiments, increasing the amount of time that the formulations disclosed herein are noticeable results in greater drug absorption and effectiveness. Non-limiting examples of mucoadhesive polymers include carboxymethylcellulose, carbomer (acrylic acid polymer), poly (methyl methacrylate), polyacrylamide, polycarbophil, acrylic acid / butyl acrylate copolymer, sodium alginate, and dextran including.

  In some embodiments, the formulation administered to the eye is administered or delivered to the posterior eye segment (eg, retina, choroid, vitreous, and optic nerve). For example, in some embodiments, a topical formulation administered to the eye disclosed herein for delivery to the posterior segment comprises a solubilizer, such as glucan sulfate and / or cyclodextrin. The glucan sulfate used in some embodiments includes, but is not limited to, dextran sulfate, cyclodextrin sulfate, and β-1,3 glucan sulfate, both natural and derivatives thereof, or fibroblast proliferation Temporarily binds to or is retained in the tissue containing the factor (FGF) and improves the stability and / or solubility of the drug and / or the eye disclosed herein Includes any compound that improves the penetration and ocular absorption of the topical formulation administered. Cyclodextrin derivatives used in some embodiments as solubilizers include, but are not limited to, α-cyclodextrin, β-cyclodextrin, γ-cyclodextrin, hydroxyethyl β-cyclodextrin, hydroxypropyl γ-cyclodextrin Hydroxypropyl β, cyclodextrin, sulfated α-cyclodextrin, sulfated β-cyclodextrin, sulfobutyl ether β-cyclodextrin.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are formulated for rectal or vaginal administration. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is administered as a suppository. In some embodiments, a composition suitable for rectal administration is a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein that is solid at ambient temperature but at rectal temperature. It is a liquid and is therefore prepared by mixing with a suitable nonirritating excipient that will dissolve in the rectum to release the drug. In some embodiments, compositions suitable for rectal administration include nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein, cocoa butter, glycerin gelatin, hydrogenated plants. It is prepared by mixing with a basic oil, a mixture of polyethylene glycols of various molecular weights, or a fatty acid ester of polyethylene glycol.

  In certain embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is a controlled release particle, lipid complex, liposome, nanoparticle, microparticle, microparticle, nanocapsule, or Optionally incorporated into other agents that enhance or facilitate local delivery to the skin. One example of a conventional microencapsulation process for a formulation is described in US Pat. No. 3,737,337, which is hereby incorporated by reference for such disclosure.

  Dose

  The amount of pharmaceutical composition administered will depend to some extent on the individual being treated. In examples where the pharmaceutical composition is administered to a human subject, the daily dosage is determined by the prescribing physician, and the dosage is generally the individual's age, gender, diet, weight, overall health and response, The severity of the individual's symptoms, the specific disease or condition being treated, the severity of the disease or condition being treated, the time of administration, the route of administration, the nature of the composition, the rate of excretion, the drug combination, and the formulation It changes according to the discretion of the doctor.

  In some embodiments, the dosage of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is from about 0.001 to about 1000 mg / kg body weight / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein ranges from about 0.5 to about 50 mg / kg / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is from about 0.001 to about 7 g / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is about 0.01 to about 7 g / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is from about 0.02 to about 5 g / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is from about 0.05 to about 2.5 g / day. In some embodiments, the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is about 0.1 to about 1 g / day.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered before, during, or during the onset of the disease or condition. In some embodiments, the combination therapy is administered before, during, or during the onset of the disease or condition. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered in combination therapy before, during, or during the onset of a disease or disorder. . In some embodiments, the timing of administering a composition comprising nHC-HA / PTX3 or rcHC-HA / PTX3 disclosed herein varies. Thus, in some instances, the nHC-HA / PTX3 or rcHC-HA / PTX3HA complex disclosed herein is used as a prophylactic agent to prevent disease or disease in order to prevent the disease or disease from occurring. It is administered continuously to subjects who tend to progress. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject during or as soon as possible after onset of symptoms. Is done. In some embodiments, administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is within the first 48 hours of symptom onset, preferably the first onset of symptom onset. Within 48 hours, more preferably within the first 6 hours of onset of symptoms, and most preferably within 3 hours of onset of symptoms. In some embodiments, the initial administration can be any route, such as intravenous infusion, bolus infusion, infusion from 5 minutes to about 5 hours, pills, capsules, transdermal patches, buccal delivery, or combinations thereof. Is done through. The nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein can be used as soon as it is feasible after the onset of the disease or disease is detected or suspected, and the time required for treatment of the disease. For example, it is preferably administered for about 1 month to about 3 months. In some embodiments, the duration of treatment varies for each subject, and the duration is determined using known criteria. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein, or a formulation comprising the compound, is at least 2 weeks, preferably from about 1 month to about 5 years. And more preferably from about 1 month to about 3 years.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered once daily in a single dose. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered in multiple doses more than once a day. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered twice daily. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered three times daily. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered four times daily. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered five or more times daily.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered for prophylactic and / or therapeutic treatments. For therapeutic use, in some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein may correct or partially block the disease or symptom of the disease. In an amount sufficient to administer to an individual already suffering from a disease or condition. Effective amounts for such use will depend on the severity and course of the disease or condition, previous therapy, individual health, weight and responsiveness to the drug, as well as the judgment of the treating physician.

  For prophylactic use, in some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to an individual at risk for a particular disorder. Such an amount is defined to be a “prophylactically effective amount or dose”. In such applications, the exact amount will vary depending on the individual's health, weight, and other physical parameters.

  If the disease of the individual does not improve, based on the judgment of the physician, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein may be used in the long term, ie, the individual's disease or symptom of the disease. Is administered over a long period of time, including during the life of the individual, to ameliorate or otherwise control or limit.

  In some embodiments, if the condition of the individual improves, is the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein administered continuously based on the judgment of the physician? Alternatively, the volume of drug being administered is temporarily reduced or temporarily suspended over a period of time (ie, “drug holiday”). In some embodiments, the length of the drug holiday is by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days. 28 days, 35 days, 50 days, 70 days, 100 days, 120 days, 150 days, 180 days, 200 days, 250 days, 280 days, 300 days, 320 days, 350 days, and 365 days, Between 2 days and 1 year. In some embodiments, the dose reduction during the drug holiday is, by way of example only, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55 %, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, or 10% to 100%, including 100%.

  Once the individual's condition improves, maintenance doses are administered as needed. In some embodiments, the dose and / or frequency of administration is then reduced, depending on the symptoms, to a level at which improvement of the disease, symptoms, or disease is maintained. In some embodiments, the individual requires long-term intermittent treatment upon the recurrence of any symptom.

  In some embodiments, the pharmaceutical compositions described herein are in unit dosage forms suitable for single administration of precise dosages. In unit dosage form, the formulation is divided into unit doses containing appropriate amounts of the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein. A unit dose is in the form of a package containing discrete amounts of the formulation. Non-limiting examples are packaged tablets or capsules and powders in vials or ampoules. In some embodiments, the aqueous suspension composition is packaged in a non-resealable container for a single dose. In some embodiments, multiple dose resealable containers are used, where it is common to include preservatives in the composition. In some embodiments, formulations for parenteral injection are provided in unit dosage form, including but not limited to ampoules with preservatives or multi-dose containers.

  A suitable daily dosage for the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is, for example, about 0.01 to 2.5 mg / kg body weight. Daily doses expressed in large mammals including but not limited to humans range from about 0.5 mg to about 100 mg, and four times a day (but not limited to) Are conveniently administered in multiple doses or in sustained release form. Unit dosage forms suitable for oral administration contain from about 1 mg to 50 mg of active ingredient. Due to the large variables associated with individual treatment regimens, the above ranges are merely suggestive and some deviation from these recommended values is not uncommon. In some embodiments, dosages as described above will vary depending on a number of variables including, but not limited to, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex used. It includes the ability of the body, the disease or condition being treated, the mode of administration, the requirements of the individual subject, the severity of the disease or condition being treated, and the judgment of the practitioner.

  In some embodiments, the toxicity and therapeutic effects of such treatment regimes include, but are not limited to, determination of LD50 (50% lethal dose of the population) and ED50 (therapeutically effective dose in 50% of the population). As determined by standard pharmaceutical procedures in cell cultures or laboratory animals. In some embodiments, the dose ratio between toxic and therapeutic effects is the therapeutic index, expressed as the ratio between LD50 and ED50. Preferred are nHC-HA / PTX3 or rcHC-HA / PTX3 complexes that exhibit high therapeutic indices. In some embodiments, data from cell culture assays and animal studies are used in formulating a range of volumes for use in humans. The dose of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is preferably within a range of blood concentrations, including ED50 with minimal toxicity. In some embodiments, the dosage varies within this range depending on the dosage form employed and the route of administration utilized.

  In some embodiments, the pharmaceutical composition of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is a packaging material, a pharmaceutical composition effective for the prevention and / or treatment of a disease or condition, and a pharmaceutical composition. The product is packaged as a product containing a label specifying that it is used to treat the disease or condition. In some embodiments, the pharmaceutical composition is packaged in a unit dosage form and includes an amount of the pharmaceutical composition for single or multiple administrations. In some embodiments, the packaged composition includes a lyophilized powder of the pharmaceutical composition that is reconstituted (eg, with water or saline) prior to administration.

  Medical device and biomaterial composition

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is assembled directly on the surface or formulated as a coating for an implantable medical device. It was. Methods of covalent bonding of hyaluronan to surfaces such as, but not limited to, metals, polymers, ceramics, silica, and composite surfaces are well known in the art, and in some embodiments, such Used with the methods provided herein to assemble nHC-HA / PTX3 or rcHC-HA / PTX3 complexes on a surface (see, eg, US Pat. No. 5,356,433; 5,336). , 518, 4,613,665, 4,810,784, 5,037,677, 8,093,365). In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is assembled directly on the surface of an implantable medical device or part thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced according to the methods provided herein is purified and then the surface of the implantable medical device or part thereof Attached directly to. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced according to the methods provided herein is purified and then bound to a medical device or part thereof. Prepared as a coating agent. In some embodiments, the coating agent is applied directly to the surface or applied to a pre-treated or coated surface, and the pretreatment and coating help to adhere the coating agent to the substrate. Intended. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced according to the methods provided herein is purified, followed by nHC-HA / PTX3 or rcHC-HA / PTX3. To a medical device or part thereof coated with a substance that facilitates binding of the complex. For example, in some embodiments, a medical device or portion thereof provides a functional group on its surface for covalent attachment of hyaluronan in a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Coated with polymer. In some embodiments, a coupling agent such as, but not limited to, carbodiimide is used to attach the nHC-HA / PTX3 or rcHC-HA / PTX3 complex to the polymer coating. In some embodiments, photo-immobilization is used to covalently attach a nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced according to the methods provided herein to a medical device or a portion thereof. Photoimmobilization is used. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes produced according to the methods provided herein use spacer molecules that contain reactive groups photochemically or thermochemically. And attached to a medical device or a part thereof.

  In some embodiments, a coating formulation comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate, for example, by dip coating. Other methods of use include, but are not limited to, spraying, cleaning, vapor deposition, brushes, rollers, curtains, spin coating, and other methods known in the art.

  Typical implantable medical devices include, but are not limited to, artificial joints, orthopedic devices, bone implants, contact lenses, sutures, surgical staples, surgical clips, catheters, angioplasty balloons, sensors, surgical instruments Electrodes, needles, syringes, wound drains, shunts, urethral inserts, metal or plastic implants, heart valves, prostheses, wrap bands, prosthetic annulus, guide wires, K-wires, or Denham pins, Stents, stent grafts, vascular grafts, pacemakers, pellets, wafers, medical tubes, infusion sleeves, implantable defibrillators, neurostimulators, glucose sensors, cerebrospinal fluid shunts, implantable drug pumps, spinal cages (spinal) cage), artificial intervertebral disc, ocular transplant, cochlear implant, breast Npuranto, replacement device for nucleus pulposus, ear tube, intraocular lens, drug delivery systems, microparticles, nanoparticles, and microcapsules thereof.

  In certain embodiments, the implantable medical device is a transplanted tissue or appliance comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In certain embodiments, the brace is an artificial joint. In some embodiments, the brace is an artificial hip joint, an artificial knee, an artificial shoulder joint, an artificial ankle.

  In some embodiments, the implant is a stent. In some embodiments, the implant is a coronary stent, ureteral stent, urethral stent, prostate stent, bone stent, or esophageal stent. In certain embodiments, the implant is a bone implant, including but not limited to an osseointegrated implant or craniofacial implant (eg, an artificial ear, an orbital brace, a nasal brace).

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is an nHC-HA / PTX3 or rcHC-HA / PTX3 complex relative to the subject. Can be assembled directly with microparticles or nanoparticles (see, for example, WO 03/015755 and US2004 / 0241248).

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein are any of those described herein or known in the art. It is attached, assembled or provided as a coating on the surface of such an implantable medical device or a part thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex elutes from the coating agent into the surrounding tissue after implantation.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is a scaffold used for the delivery of biomaterials such as stem cells or insulin producing cells. Assembled directly on microparticles, microcapsules, or microcarriers. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are attached directly to or assembled on a microcapsule. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is combined with the material used to form the microcapsules, or nHC-HA / PTX3 or rcHC-HA. Microcapsules containing the / PTX3 complex are produced. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to cover the inner surface of the microcapsules. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to cover the outer surface of the microcapsules. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to cover the inner and outer surfaces of the microcapsules.

  Exemplary materials for encapsulating cells include, but are not limited to, agarose, alginate, and artificial polymers such as poly (NiPAAm-co-AAC), poly (ethylene glycol) (PEG), and Thermosetting hydrogels such as PEG derivatives such as PEG diacrylate and oligo (poly (ethylene glycol)) fumarate. Stem cell culture and microencapsulation methods, in some embodiments, are known in the art and include the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein. Used to produce microcapsules.

  In some embodiments, the microcapsule includes a cell, a plurality of cells, or other biomaterial. In some embodiments, the cell is a stem cell, such as but not limited to a mesenchymal stem cell. In some embodiments, the cell is a differentiated cell, such as but not limited to an insulin producing cell. In some embodiments, the cell is an autologous cell (ie, a cell from or derived from a recipient of the cell). In some embodiments, the cell is an allogeneic cell (ie, a cell that is not from or not derived from the recipient of the cell). In some embodiments, the microcapsule includes a cell, a plurality of cells, or other biomaterial, and the inner surface of the microcapsule is an nHC-HA / PTX3 or rcHC-HA provided herein. Coated with / PTX3 complex. In some embodiments, the microcapsule includes a cell, a plurality of cells, or other biomaterial, and the outer surface of the microcapsule is an nHC-HA / PTX3 or rcHC-HA provided herein. Coated with / PTX3 complex. In some embodiments, the microcapsule includes a cell, a plurality of cells, or other biomaterial, and the outer surface and inner surface of the microcapsule are nHC-HA / PTX3 or rcHC provided herein. -Coated with a composite of HA / PTX3. In some embodiments, the microcapsules are administered to treat a disease or condition. Exemplary diseases and conditions and methods of treatment that can administer the microcapsules are specified elsewhere herein and include, but are not limited to, diseases associated with inflammation and immunity.

(Treatment method)
In certain embodiments, disclosed herein are methods of treating an individual, the method comprising administering to the individual a nHC-HA / PTX3 or rcHC-HA / PTX3 complex as described herein. including. In certain embodiments, a method of treating an individual is disclosed herein, wherein the method comprises a nHC-HA / PTX3 or rcHC-HA / PTX3 complex produced by a method described herein. Administering to an individual. The following are examples of non-limiting treatment methods, including administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are used to inhibit at least one of the following: scar, inflammation, autoimmunity Or a condition that requires an immune response, adhesion, angiogenesis, and cell or tissue regeneration leading to immune rejection. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are used to promote wound healing. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are used to promote stem cell expansion. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are used to promote tissue regeneration.

  In some embodiments, a method of treating an individual is disclosed herein, which method comprises any nHC-HA / PTX3 or rcHC-HA / PTX3 combination described herein by any suitable method. Administering the body to the individual. In some embodiments, a method of treating an individual is disclosed herein, which method comprises any nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein, by any suitable route of administration. Administering the body to the individual. The appropriate method for administration depends on the disease or condition being treated. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered locally at the site of treatment. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered systemically. Exemplary methods for administration of nHC-HA / PTX3 or rcHC-HA / PTX3 provided herein include, but are not limited to, parenteral, enteral, subcutaneous, transdermal, transdermal, skin Including internal, intravenous, topical, inhalation, or transplantation.

  Scar

  In certain embodiments, a method for preventing, reducing, or reversing a subject's scar is described herein, the method comprising nHC-HA / PTX3 or rcHC-HA / PTX3 as disclosed herein. Administering to the subject a composition comprising the complex.

  As used herein, “scarring” refers to scar formation. In one aspect, the scar is a hypertrophic scar, a keloid scar, or a scar derived from acne. As used herein, a “scar” is a region of fibrous tissue that results from overproduction of collagen. In certain instances, wound healing involves the migration of fibroblasts to the site of injury. In certain instances, fibroblasts precipitate collagen. In certain instances, fibroblasts precipitate excess collagen at the wound site, resulting in scarring.

  In certain instances, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein prevent or inhibit TGF-β signaling. In particular examples, TGF-β stimulates extracellular matrix degradation by stimulating fiber growth and collagen deposition and inhibiting extracellular matrix degradation (by upregulating the synthesis of protease inhibitors). Control. In certain instances, preventing or inhibiting the expression of TGF-β results in prevention of scarring or a reduction in scar intensity. In some embodiments, administration of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein prevents or reduces scarring.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein inhibit or prevent fibroblasts' ability to differentiate into myofibroblasts. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein return differentiated myofibroblasts to fibroblasts.

  In some embodiments, the methods disclosed herein are used to prevent, reduce or reverse scar formation. In some embodiments, the methods disclosed herein may be used to convert the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein to scarring (eg, dermatitis scars, keloids). Administration to an individual having a disorder that results in scars, spastic scars, hypertrophic scars, or scars caused by acne. In some embodiments, the methods disclosed herein may provide an individual in need of an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein before and after trauma. Administering. In some embodiments, the methods disclosed herein provide an individual in need with an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein before and after surgery. Administering.

  In some embodiments, the methods disclosed herein are used to prevent or reduce scar formation in the eyes or surrounding tissue. In some embodiments, the methods disclosed herein may be used to treat individuals with disorders (eg, retinopathy of prematurity) that result in scarring of the eyes or surrounding tissues, with the nHC-HA / Administering a PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the methods disclosed herein may be used to provide an individual in need before or after trauma to the eye or surrounding tissue to nHC-HA / PTX3 or rcHC- Administering a HA / PTX3 complex. In some embodiments, the methods disclosed herein may be used to provide nHC-HA / PTX3 or rcHC− disclosed herein to an individual in need before or after surgery on the eye or surrounding tissue. Administering a HA / PTX3 complex.

  inflammation

  In certain embodiments, a method for preventing or reducing inflammation in a subject is described herein, the method comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 combination disclosed herein. Administering to the subject a composition comprising the body. As used herein, “inflammation” refers to plasma and / or white blood cells (eg, lymphocytes, macrophages) to the site of infection or trauma (eg, blunt trauma, sharp trauma, or surgery). , Granulocytes, and neutrophils).

  In certain instances, leukocytes secrete cytokines after contact with the antigen. As used herein, a “cytokine” is a signaling protein or glycoprotein. In certain instances, the cytokine binds a receptor to the surface of the cell. In certain instances, cytokines cause leukocyte chemotaxis to the site of infection. In certain instances, cell surface receptors on leukocytes detect a chemical gradient of cytokines. In certain instances, leukocytes are accompanied by a gradient relative to the site of infection. In certain instances, the binding of cytokines to cell surface receptors results in up-regulation or down-regulation of specific genes and their transcription factors. In certain instances, altered gene expression results in cytokine production, increased cytokine production, or increased cell surface receptor presentation.

  As non-limiting examples, cytokines include interleukins IL-1, IL-6, IL-8, MCP-1 (also known as CCL2), and TNF-α. Interleukin 1 is in the body in two isoforms: IL-1α and IL-1β. In certain instances, the presence of IL-1 increases adhesion factor expression on endothelial cells. This in turn allows extravascular movement of leukocytes to the site of infection. In certain instances, IL-8 induces leukocyte chemotaxis. In certain instances, TNF-α induces leukocyte chemotaxis. In certain instances, MCP-1 recruits leukocytes to the site of tissue damage and infection.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein inhibit cytokine production and / or activity. In certain instances, reducing the cytokine concentration reduces or prevents inflammation by reducing the number of white blood cells and / or the rate of white blood cell migration to the site of injury.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein cause apoptosis of leukocytes (eg, macrophages, neutrophils, or lymphocytes). In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein reduces the number of activated leukocytes or the rate at which leukocytes are activated. In certain instances, reducing the concentration of leukocytes reduces or prevents inflammation by reducing the number of cells that migrate to the site of injury (eg, promoting the death of such cells through apoptosis).

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein inhibits macrophage polarization to an inflammatory phenotype (ie, the M1 phenotype). To do. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein reduce or inhibit IL-12 or IL-23 expression in stimulated macrophages. . In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is polarized to stimulated macrophages to a regulatory or wound healing M2 phenotype. Prompt. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein inhibit or reduce inflammation in a subject. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein inhibit or reduce tissue damage caused by a subject's inflammatory response. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces tissue damage caused by a disease or disorder that causes inflammation in a subject.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with inflammation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with acute inflammation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with chronic inflammation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with an inflammatory disorder. In some embodiments, the inflammatory disorder is a macrophage-mediated inflammatory disorder. In some embodiments, the inflammatory disorder is a T cell mediated inflammatory disorder. In some embodiments, the inflammatory disorder is a Th-17 mediated immune disorder.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with an acute inflammatory response. In some embodiments, the acute inflammatory response is caused by, for example, allergy, sepsis, endotoxin shock or ischemia, such as but not limited to myocardial infarction or stroke. In some embodiments, the acute inflammatory response is the result of a bacterial infection, a protozoal infection, a protozoal infection, a viral infection, a fungal infection, or a combination thereof. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces acute inflammation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces tissue damage caused by acute inflammation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces tissue reperfusion injury due to ischemia including myocardial infarction and stroke.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is administered to a subject with chronic inflammation associated with lymphocyte activation by adaptive immunity. The In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered to a subject with a Th1 response. In some embodiments, a Th1 response leads to immune rejection of a biological transplant. In some embodiments, the graft is an allograft. In some embodiments, the graft is an autograft. In some embodiments, the inflammatory disorder is graft versus host disease or tissue transplant rejection. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces chronic inflammation in a subject.

  In some embodiments, an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is administered to a subject with chronic inflammation associated with a Th17 immune response associated with an inflammatory disorder. Is done. In some embodiments, the inflammatory disorder is an autoimmune disease or a white blood cell defect.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is an acute disseminated encephalomyelitis, Addison's disease; ankylosing spondylitis; antiphospholipid antibody syndrome Autoimmune hemolytic anemia; autoimmune hepatitis; autoimmune inner ear disease; bullous pemphigoid; Chagas disease; chronic obstructive pulmonary disease; celiac disease; dermatomyositis; type 1 diabetes; type 2 diabetes; Goodpasture syndrome; Graves' disease; Guillain-Barre syndrome; Hashimoto's disease; idiopathic thrombocytopenic purpura; interstitial cystitis; systemic lupus erythematosus (SLE); metabolic syndrome, multiple sclerosis; Disease; myocarditis, narcolepsy; obesity; pemphigus vulgaris; pernicious anemia; polymyositis; primary biliary cirrhosis; rheumatoid arthritis; schizophrenia; Group: Vasculitis; Vitiligo; Wegener's granulomatosis; Allergic rhinitis; Prostate cancer; Non-small cell lung cancer; Ovarian cancer; Breast cancer; Melanoma; Gastric cancer; Colitis; Crohn's disease; Collagen colitis; Lymphocytic colitis; Ischemic colitis; Diversity colitis; Behcet's syndrome; Infectious colitis; Indeterminate colitis; , Myocardial infarction, stroke, endotoxin shock, septic shock; rheumatic spondylitis, ankylosing spondylitis, gouty arthritis, rheumatic polymyalgia, Alzheimer's disease, Parkinson's disease, epilepsy, AIDS, dementia, asthma, adult Respiratory distress syndrome, bronchitis, cystic fibrosis, acute leukocyte-mediated lung injury, distal proctitis, wege -Granulomatosis, connective tissue, uveitis, conjunctivitis, psoriasis, eczema, dermatitis, smooth muscle proliferative disorder, meningitis, shingles, encephalitis, nephritis, tuberculosis, retinitis, atopic dermatitis, pancreatitis , Periodontal gingivitis, coagulation necrosis, liquefaction necrosis, fibrin necrosis, neointimal hyperplasia, or a combination thereof is administered to a subject with an inflammatory disorder.

  In some embodiments, the inflammatory disorder is an inflammatory disorder of the eye or surrounding tissue. In some embodiments, the inflammatory disease is conjunctivitis. In certain instances, conjunctivitis results from allergen exposure. In certain instances, conjunctivitis results from a bacterial infection. In some embodiments, the inflammatory disease is keratitis. As used herein, “keratitis” is a disorder characterized by keratitis. In some embodiments, the inflammatory disorder is keratoconjunctivitis (ie, a combination of conjunctivitis and keratitis (ie, corneal inflammation)). In some embodiments, the inflammatory disorder is blepharitis. As used herein, “blinditis” is an eye disorder characterized by inflammation of the lid margin. In some embodiments, the inflammatory disorder is eyelid conjunctivitis (ie, a combination of conjunctivitis and eyelid inflammation (ie eyelid inflammation)). In some embodiments, the inflammatory disorder is scleritis. As used herein, “scleratis” is a disorder characterized by inflammation of the sclera. In some embodiments, the inflammatory disorder is episclerosis. As used herein, “suprasclitis” is an inflammatory disorder of the superior sclera characterized by hyperemia and conjunctival edema. In some embodiments, the inflammatory disorder is uveitis. As used herein, uveitis is an inflammatory and disorder of the uvea. In some embodiments, the disorder is retinitis. As used herein, “retinitis” is an inflammatory disorder of the retina. In some embodiments, the disorder is choroiditis. As used herein, “choroiditis” is an inflammatory disorder of the uvea, ciliary body, and choroid.

  Abnormal angiogenesis

  In certain embodiments, disclosed herein are methods for preventing or reducing angiogenesis in a subject, the methods comprising nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein. Administering a composition comprising: to a subject. As used herein, “angiogenesis” refers to the formation of new blood vessels. In certain instances, angiogenesis promotes tumor growth and metastasis. Further, in certain instances, abnormal angiogenesis is the basis for wet age-related macular degeneration (wARMD) and diabetic proliferative retinopathy. In certain instances, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein prevent or reduce angiogenesis.

  In certain instances, binding of a ligand to VEGF receptor-2 (VEGFR-2) initiates a tyrosine kinase signaling cascade that is vascular permeability (eNOS producing NO), proliferation / survival ( bFGF), migration (ICAM / VCAM / MMP), and finally the production of factors that variously stimulate differentiation into mature blood vessels. In certain instances, after VEGFR-2 binds to its ligand, the endothelial cells form a tube structure that resembles a capillary.

  As used herein, “wet age-related macular degeneration”, “wARMD”, or “wet ARMD” refers to an eye disorder characterized by the growth of blood vessels from the choroid. In certain instances, wet ARMD causes vision loss due to blood and protein leakage below the macula. In certain instances, bleeding, leakage, and scarring from these vessels results in irreversible damage to photoreceptors and rapid vision loss if left untreated.

  As used herein, “diabetic proliferative retinopathy” refers to an eye disorder characterized by vascular wall dysfunction. In certain instances, lack of oxygen in the retina causes angiogenesis along the retina and in the vitreous humor. In certain instances, new blood vessels bleed, cloud vision and destroy the retina.

  In certain instances, capillary growth nourishes the tumor and causes it to expand. In certain instances, capillary growth allows for rapid removal of cellular waste and allows tumor growth. In certain instances, angiogenesis promotes metastasis. In certain instances, capillary growth increases the likelihood that cancer cells can enter blood vessels and establish new tumors at new sites.

  In some embodiments, exemplary cancer types treated using the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes described herein include, but are not limited to, acute lymphoblastic Leukemia, acute myeloid leukemia, adrenocortical cancer, AIDS-related cancer, AIDS-related lymphoma, anal cancer, astrocytoma, basal cell cancer, bile duct cancer, bladder cancer, bladder cancer, bone cancer, brain stem glioma, brain tumor, Breast cancer, bronchial adenoma, Burkitt lymphoma, carcinoma, cancer, central nervous system lymphoma, cerebellar astrocytoma, cervical cancer, chronic lymphocytic leukemia, chronic myelogenous leukemia, chronic myeloproliferative disease, colon cancer, colorectal cancer Cutaneous T cell lymphoma, endometrial cancer, ventricular ependymoma, esophageal cancer, extragonadal germ cell tumor, eye cancer, intraocular melanoma, eye cancer, retinoblastoma, gallbladder cancer, gastrointestinal carcinoid tumor, Gastrointestinal stromal tumor (GIST) , Germ cell tumor (extracranial), germ cell tumor (extragonadal), germ cell tumor (ovary), trophoblastic tumor, glioma, hairy cell leukemia, head and neck cancer, hepatocellular (liver) cancer, Hodgkin Lymphoma, hypopharyngeal carcinoma, glioma of the hypothalamus and visual tract, intraocular melanoma, islet cell carcinoma (endocrine pancreas), Kaposi sarcoma, kidney (renal cell) cancer, laryngeal cancer, leukemia (acute lymphoblastic) , Leukemia (acute myeloid), leukemia (chronic lymphocytic), leukemia (chronic myeloid), lip and oral cancer, liver cancer, lung cancer (non-small cell), lung cancer (small cell), lymphoma (skin T Cell), lymphoma (non-Hodgkin), bone / osteosarcoma malignant fibrous histiocytoma, medulloblastoma, melanoma, Merkel cell carcinoma, mesothelioma, unexplained metastatic cervical squamous cell carcinoma, multiple endocrine glands , Multiple myeloma / plasma cell tumor, mycosis fungoides, myelodysplastic syndrome, bone Dysplasia / myeloproliferative disease, myeloid leukemia, myeloid leukemia, myeloproliferative disease, nasal and sinus cancer, nasopharyngeal cancer, neuroblastoma, oral cancer, oropharyngeal cancer, osteosarcoma / malignant fiber of bone Histiocytoma, ovarian cancer, ovarian epithelial cancer, ovarian germ cell tumor, low-grade ovarian tumor, pancreatic cancer, parathyroid cancer, penile cancer, pheochromocytoma, pineoblastoma and supratentorial primitive neuroepithelial tumor, Pituitary tumor, plasma cell tumor / multiple myeloma, pleuropulmonary blastoma, prostate cancer, rectal cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, sarcoma (Kaposi), sarcoma (uterus), Sezary syndrome, Skin cancer (non-melanoma), skin cancer (melanoma), skin cancer (Merkel cell), small intestine cancer, soft tissue sarcoma, squamous cell carcinoma, stomach (stomach) cancer, T cell lymphoma, testicular cancer, thymoma, thyroid cancer , Trophoblastic tumor, gestational urethral cancer, uterine cancer, endometrial uterine meat Tumors, vaginal cancer, glioma of the visual tract and hypothalamus, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms tumor.

  Wound healing and tissue regeneration

  In some embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a wound dressing or to promote wound healing used. In some embodiments, the tissue is damaged, compromised, or lost due to injury (eg, burns, surgical incisions, infections, trauma, or areas of necrosis resulting from toxins, lacerations). In some embodiments, the tissue has been damaged, compromised or lost due to burns. In some embodiments, the tissue has been damaged, compromised, or lost due to a wound (eg, incision, laceration, wear). In some embodiments, the tissue has been damaged, compromised, or lost due to necrosis. In some embodiments, the tissue has been damaged, compromised or lost due to ulcers.

  Burn

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a burn. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to first degree burns. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to second degree burns. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to third degree burns. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the burn.

  wound

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is a skin wound (eg, incision, laceration, wear, ulcer, puncture) , Through). In some embodiments, the wound is an ischemic wound. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the wound. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats a wound.

  In some embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is an incision of an organ (eg, skin, brain, stomach, kidney, liver). , Intestines, lungs, bladder, trachea, esophagus, vagina, ureters, and blood vessel walls). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a surgical incision. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to the site of colectomy. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to the site of gastrectomy. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 disclosed herein comprises breast surgery (eg, breast reduction surgery, breast augmentation surgery, And mastectomy). In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the wound.

  In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 disclosed herein is a skin incision (eg, epithelium, dermis, and / or subcutaneous tissue). Used as a coating on the incision). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to repair or supplement the skin after hemorrhoid surgery . In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the wound. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats a wound.

  Necrosis

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises a protective graft over a region of necrotic tissue (eg, from an infection). Used as (protective graph). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used in a protective graft over a region of necrotic skin. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is placed in the area of necrotic tissue. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to a substrate prior to being placed on necrotic tissue. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats necrotic tissue.

  Ulcer

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a protective coating on an ulcer. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats an ulcer. In some embodiments, the ulcer is a diabetic ulcer, such as a diabetic foot lesion or a leg ulcer. In some embodiments, the ulcer is an ischemic wound. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the ulcer. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats an ulcer. In some embodiments, the ulcer is a non-healing ulcer. For example, in some embodiments, a non-healing ulcer is a wound or ulcer on the skin that has been present for about 3-4 weeks without treatment.

  In some embodiments, the ulcer is a foot ulcer (eg, a diabetic foot ulcer or an arterial ulcer). In some embodiments, the treatment of foot ulcer comprises (a) preparing a wound (eg, by wiping the wound) and (b) nHC-HA / PTX3 or rcHC disclosed herein. Placing a pharmaceutical composition comprising a complex of HA / PTX3 on the wound. In some embodiments, the treatment of foot ulcers comprises: (a) preparing a wound (eg, by wiping the wound); and (b) nHC-HA / PTX3 or rcHC disclosed herein. -Placing the pharmaceutical composition comprising the HA / PTX3 complex on the wound; and (c) covering the pharmaceutical composition with a protective wall (eg, Silvercell dressing, metipel, gauze, or bandage). Including. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the ulcer. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats an ulcer.

  In some embodiments, the ulcer is a venous stasis (VS) ulcer. In some embodiments, treatment of VS ulcer comprises (a) preparing a wound (eg, by wiping the wound) and (b) nHC-HA / PTX3 or rcHC disclosed herein. -Placing a pharmaceutical composition comprising the HA / PTX3 complex on the wound. In some embodiments, treatment of VS ulcer comprises (a) preparing a wound (eg, by wiping the wound) and (b) nHC-HA / PTX3 or rcHC disclosed herein. -Placing the pharmaceutical composition comprising the HA / PTX3 complex on the wound and (c) covering the pharmaceutical composition with a protective barrier (eg, wound veil, antimicrobial dressing, gauze, or bandage). In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the wound. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats an ulcer.

  In some embodiments, the ulcer is a corneal ulcer (ie, ulcerative keratitis). In some embodiments, the treatment of corneal ulcer comprises (a) preparing a wound (eg, by wiping the wound) and (b) nHC-HA / PTX3 or rcHC disclosed herein. -Placing a pharmaceutical composition comprising the HA / PTX3 complex on the wound. In some embodiments, the treatment of corneal ulcer comprises (a) preparing a wound (eg, by wiping the wound) and (b) nHC-HA / PTX3 or rcHC disclosed herein. -Placing the pharmaceutical composition comprising the HA / PTX3 complex on the wound and (c) covering the pharmaceutical composition with a protective wall (eg contact lens or bandage). In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to the substrate prior to being placed on the wound. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats an ulcer.

  Treatment with therapeutic cells

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered in combination with cell therapy. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with therapeutic cells. A therapeutic cell includes any cell that exhibits therapeutic properties for the treatment of a disease or condition. In some embodiments, the therapeutic cell is a recombinant cell that heterologously expresses one or more therapeutic gene products. In some embodiments, the therapeutic cells are transplanted. In some embodiments, the therapeutic cell is a stem cell. In some embodiments, the therapeutic cell is a cell that expresses one or more stem cell markers (eg, Oct-3 / 4 (Pou5f1), Sox2, c-Myc, and Klf4).

In some embodiments, the cell therapy is stem cell transplantation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is administered to promote transplant stem cell expansion and tissue regeneration. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to reduce or inhibit inflammation, scarring, and abnormal angiogenesis caused by stem cell transplantation Is done. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to maintain stem cell characteristics during expansion in vitro by replacing the feeder cell layer. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 complexes are used to reprogram differentiated cells into stem cells. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are then expanded and cultured in vitro for stem cell transplantation into a subject. Used as needed.

In some embodiments, the stem cell therapy is embryonic stem cell therapy. In some embodiments, the stem cell therapy is an adult stem cell therapy. In some embodiments, the stem cell therapy is a mesenchymal stem cell therapy. In some embodiments, stem cell therapy includes, but is not limited to, heart disease, cancer, diabetes, spinal cord injury, neurodegenerative disease, Alzheimer's disease, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, Duchenne type It is given for the treatment of diseases or disorders such as muscular dystrophy, muscle damage or dystrophy, stroke, burns, lung disease, retinal disease, kidney disease, osteoarthritis, and rheumatoid arthritis.

  In some embodiments, stem cells are used to treat diabetes. Type 1 diabetes is due to autoimmune-mediated destruction of insulin-secreting β-cells in the pancreatic islets of Langerhans. Type 2 diabetes is due to systemic insulin resistance and decreased insulin secretion by pancreatic β-cells. Stem cells have been shown in vitro to differentiate into insulin producing cells (see, eg, Schuldiner et al. (2000) Proc. Natl. Acad. Sci. USA. 97: 11307-11212; Guo et al., (2009). ) See Endocr Rev 30: 214-227). Thus, in some embodiments, stem cells comprising ESC and ASC, and derivatives thereof such as partially differentiated stem cells are used in stem cell therapy for regeneration of pancreatic β cells.

  In some embodiments, stem cells or differentiated cells used for therapy are encapsulated in a microcapsule device. In some embodiments, the microcapsule comprises a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is covalently bound to the microcapsule. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is assembled on the surface of the microcapsule, eg, the inner or outer surface, or both. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 is formulated to coat microcapsules. In some embodiments, the microcapsules comprise pores that allow nutrient passages to the cells to reach the microcapsules and / or proteins and molecules secreted by the encapsulated cells (eg, , Insulin) can flow out of the microcapsules. In some embodiments, the cells are first fixed on a microcarrier, such as a Matrigel®-coated bead, and then encapsulated in a microcapsule. For example, methods for encapsulation of cells such as stem cells are known in the art, see, eg, Serra et al. (2011) PLoS ONE 6 (8): e23212. In some embodiments, any method for cell encapsulation is used with the methods provided herein.

  In some embodiments, allogeneic therapeutic stem cells (eg, insulin producing islet cells) are encapsulated in a microcapsule device for the production of insulin. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex promotes stem cell expansion. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces the inflammatory response to microcapsules comprising stem cells used for the treatment of diabetes. In some embodiments, the microcapsule comprises a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex inhibits or reduces the inflammatory response to microcapsules comprising stem cells.

  Use of soft tissue

  In certain embodiments, a book for repairing, reconstituting, replacing, or replenishing a recipient's damaged, compromised, or lost soft tissue (eg, tendon) The use of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed in the specification is disclosed herein. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied directly to the tissue. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is administered with a cell or tissue based therapy. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is mixed with a cell, a plurality of cells, or a tissue, It is administered as part of a based treatment. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to cover a cell, a plurality of cells, or a tissue, Administered as part of a tissue-based treatment.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a coating over a soft tissue incision (eg, Forming a tissue surface between different layers of soft tissue). In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is applied to a matrix and then used as a coating over soft tissue incisions (eg, eyelids are Forming a tissue surface between different layers of soft tissue).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a (plastic) support for soft tissue structures. . In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein prevents adhesion in joint or tendon repair.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises a tendon or joint repair (rotator rotator cuff repair, hand tendon Used in the repair etc.). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to strengthen a tendon or joint. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises a healing tendon in the surrounding tissue, tendon or joint. Used to prevent gluing. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to prevent the formation of scar tissue in a tendon.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or Matrix / rcHC-HA / PTX3 complex used to strengthen small tendons and ligaments in the foot and ankle, including posterior tibial tendon, radial tendon, flexor and extensor tendons, and outer ankle ligaments Is done. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to enhance primary repair of the patella tendon surrounding the quadriceps and knee. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a periosteal patch for joint replacement bone grafts. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to reinforce insufficient gluteal and knee capsules after a total joint revision surgery.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used in the repair of torn rotator cuffs. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a patch over the rotator cuff muscle or tendon (eg, the supraspinatus tendon). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to reconstitute the rotator cuff muscle or tendon (eg, the supraspinatus tendon). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to augment the rotator cuff muscle or tendon (eg, the supraspinatus tendon). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to strengthen the rotator cuff muscle or tendon (eg, the supraspinatus tendon). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to prevent soft tissue adhesion to the rotator cuff muscle or tendon (eg, supraspinatus tendon).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used in gingival repair. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used in the repair of gingival recession. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a matrix and used as a gingival patch. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and used as a patch over an exposed root surface . In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to reconstitute gingiva. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to augment gingiva. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to strengthen gingiva. In some embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to prevent soft tissue adhesion to the gingiva.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is applied to a substrate and the substrate / nHC-HA / PTX3 or substrate The / rcHC-HA / PTX3 complex is used as a protective graft across the incision or rupture of the fascia. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support in the fascia. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a fascia replacement or supplement. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used to repair hernias (eg, to repair fascia). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used to repair inguinal hernias. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to repair femoral hernias. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, substrate / The rcHC-HA / PTX3 complex is used to repair umbilical hernia. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to repair scar hernias. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used to repair diaphragmatic hernia. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or Matrix / rcHC-HA / PTX3 complex is a cooper hernia, epigastric hernia, hiatal hernia, little hernia, lumbar hernia, middle hernia, obturator hernia, pantalon hernia, paraesophageal hernia, paraumbilical hernia, perineal hernia, Used to repair preperitoneal hernia, rictohernia, slipping hernia, sciatic hernia, spigelian hernia, sports hernia, belpohernia, or amiand hernia.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to repair spinal disc herniation. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a protective graft across the spinal disc incision or rupture. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a protective graft across the incision or rupture of the annulus fibrosus. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the spinal disc. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the annulus fibrosus. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a spinal disc replacement or supplement. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the spinal disc. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as annulus replacement or supplement.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used across an incision in one (or all) of the brain or meninges (ie, dura mater, buffy coat and / or arachnoid membrane). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex serves as a structural (plastic) support for one (or all) of the meninges (ie dura mater, buffy coat and / or arachnoid membrane) used. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a substitute for one (or all) of the meninges (ie dura mater, buffy coat and / or arachnoid membrane).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used across lung or pleural incisions. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the pleura. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a substitute for the pleura.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used across the tympanic incision. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the tympanic membrane. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a substitute for the tympanic membrane.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a protective graft across an incision in the heart or pericardium. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the pericardium. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a pericardial substitute.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a protective graft across the incision in the peritoneum. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the peritoneum. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a peritoneal substitute.

  Ophthalmic use

  In certain embodiments, disclosed herein for repairing, reconstituting, replacing, or replenishing a recipient's damaged, endangered, or losing eye tissue. Use of a pharmaceutical composition comprising a modified nHC-HA / PTX3 or rcHC-HA / PTX3 complex is disclosed herein.

  Glaucoma treatment

  As used herein, “glaucoma” refers to a disorder characterized by the loss of optic nerve cells in the optic nerve. In certain instances, glaucoma is due in part or completely to increased intraocular pressure in the anterior chamber (AC). Intraocular pressure varies depending on the production of liquid aqueous humor in the ciliary process of the eye and drainage of the aqueous humor through the trabecular meshwork.

  A glaucoma drainage device (GDD) is a medical device implanted in the eye to relieve intraocular pressure by providing an alternative route to drain aqueous humor. If left uncoated, the GDD tube erodes, making the eye susceptible to infections within the eye. Therefore, it is necessary to coat the GDD tube. Currently, the patches used to coat GDD tubes are made from the pericardium, sclera, and cornea. These patches are about 400-550 microns thick. Such thin patches can result in a 25% melt in two years and leave the shunt tube exposed again.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used to coat the GDD tube. In some embodiments, the substrate / nHC-HA / PTX3 or rcHC-HA / PTX3 complex is 300-600 microns thick. In some embodiments, the substrate / nHC-HA / PTX3 or substrate / rcHC-HA / PTX3 complex does not dissolve as much as 25% in 2 years.

  Eye ulcer treatment

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate, and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to cover persistent epithelial defects and / or ulcers of the eye.

  In some embodiments, the base of the ulcer is wiped with a surgical sponge and has poor adhesion adjacent to the end of the ulcer (eg, to the part of the eye where the epithelium becomes fully attached) The epithelium is removed. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is transferred to the eyes of the recipient. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is then embedded in a suture knot (eg, a knotted 10-0 nylon suture or a continuous 10-0 nylon suture). Fixed to the eye. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is immobilized on the eye by using fibrin glue. In some embodiments, the protective layer is applied to the substrate / nHC-HA / PTX3, or the substrate / rcHC-HA / PTX3 complex, or the entire eye (eg, contact lens). In some embodiments, the substrate / nHC-HA / PTX3 or substrate / rcHC-HA / PTX3 complex further comprises an antibiotic (eg, neomycin, polymyxin b sulfate, and dexamethasone).

  Reconstruction of the surface of the conjunctiva, sclera, eyelids, and orbital margin

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used to reconstitute the conjunctiva, sclera, eyelids, and orbital marginal surfaces. In some embodiments, the damage to the surface of the conjunctiva is lysis of Ryukyu adhesions, surgical removal of tumors, lesions, and / or scar tissue, laser refraction keratotomy with excimer laser and therapeutic cornea Due to resection, or a combination thereof.

  Coronary artery use

  In certain embodiments, disclosed herein for repairing, reconstituting, replacing, or replenishing a recipient's damaged, endangered, or lost coronary artery Use of a pharmaceutical composition comprising a modified nHC-HA / PTX3 or rcHC-HA / PTX3 complex is disclosed herein.

  Prevention of ischemia-reperfusion injury

  NHC-HA / PTX3 or rcHC-HA / PTX3 combinations disclosed herein for inhibition or reduction of tissue damage resulting from acute acute inflammation caused by ischemia, eg, myocardial infarction or stroke The use of a pharmaceutical composition comprising the body is disclosed herein. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to treat ischemic diseases such as, but not limited to, myocardial infarction or stroke. Administered to the subject.

  Coronary artery bypass grafting

  Disclosed herein is the use of a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein in coronary artery bypass grafting. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate, and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is implanted into the coronary artery to bypass the portion of the artery that is characterized by atherosclerosis.

  Heart valve

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is applied across the heart valve. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for heart valves. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as an alternative to heart valves.

  Veins and arteries

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is applied to blood vessels or arteries. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for blood vessels or arteries.

  Neural use

  In certain embodiments, disclosed herein for repairing, reconstituting, replacing, or supplementing a recipient's damaged, endangered, or missing neural tissue. Use of a pharmaceutical composition comprising a modified nHC-HA / PTX3 or rcHC-HA / PTX3 complex is disclosed herein.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a coating over nerves (eg peripheral nerves). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a covering over nerve grafts, nerve transitions, or repaired nerves. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a coating over an incision in a nerve (eg, peripheral nerve). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a structural (plastic) support for nerves (eg peripheral nerves). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein prevents adhesion in nerve repair.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The matrix / rcHC-HA / PTX3 complex is used as a non-contracting enclosure for damaged nerves. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein comprises scar formation, encapsulation, chronic compression, nerve restraint. ) And prevent or minimize nerve entrapment. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein prevents or minimizes neuroma formation. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein comprises an endogenous growth factor (ie, a neuron) present during nerve repair. Prevent or minimize migration of growth factors).

  Spinal cord use

  In certain embodiments, disclosed herein is the use of a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex as described herein during spinal surgery.

  In some embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is used during laminectomy. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex as described herein is an epidural fiber after spinal surgery (eg, laminectomy). Used to reduce or prevent symptoms and / or scar adhesion. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein overlaps the dura after spinal surgery (eg, laminectomy). Injected between different tissues. In some embodiments, after spinal surgery (eg, laminectomy), the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein between the dura mater and the overlying tissue is included. Injection of the pharmaceutical composition reduces or prevents fibroblast migration into the dura mater and collagen deposition on the dura mater.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex as described herein provides for the progression of proliferative scarring after spinal surgery (eg, laminectomy). Used to reduce or prevent. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is an epidural / post-surgical (eg, after laminectomy). Used to reduce or prevent the progression of scar on the dura mater / perineural. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is proliferative scarring after spinal surgery (eg, laminectomy). Used to reduce or prevent the progression of. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to reduce or prevent membrane progression after laminectomy Is done.

  In some embodiments, a pharmaceutical composition comprising nHC-HA / PTX3 or a rcHC-HA / PTX3 complex described herein is used for epidural compression or stiffness after spinal surgery (eg, laminectomy). Used to reduce or prevent the progress of membrane tethering. In some embodiments, the pharmaceutical composition comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 complex described herein is a tethered nerve root after spinal surgery (eg, laminectomy). Used to reduce or prevent the progression of. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex as described herein provides for the progression of arachitis after spinal surgery (eg, laminectomy). Used to reduce or prevent.

  In some embodiments, a pharmaceutical composition comprising an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein further comprises bone tissue that has been morselized. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprising bone tissue divided into small pieces is provided during a spinal fusion procedure. Used for. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprising bone tissue divided into pieces is injected between adjacent vertebrae. Is done. In some embodiments, of a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprising bone tissue divided into pieces between two adjacent vertebrae Injection promotes vertebral fusion.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a protective graft across an incision in the dura mater. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as a structural (plastic) support for the dura mater. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a substrate and the substrate / nHC-HA / PTX3, or The substrate / rcHC-HA / PTX3 complex is used as an alternative to the dura mater.

  Various uses of nHC-HA / PTX3 or rcHC-HA / PTX3 complexes

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is applied to a patch or wound dressing.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as a skin filler. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is injected into a decorative paper under the skin. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 disclosed herein comprises facial wrinkles and an aging line (eg, spinal line, melomental folds, “crow's feet” and frontal wrinkles). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used for lip enlargement. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is injected into the lips.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is an arthritis (eg, osteoarthritis, rheumatoid arthritis, purulent arthritis). , Ankylosing spondylitis, spondylosis). In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is injected into an arthritic joint (eg, knee).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to treat foot arthritis. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises a first metatarsophalangeal (MTP) joint (eg, strong Used to treat arthritis of gobo). In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 disclosed herein is administered to an MTP joint after dorsal cheletomy Is done. In some embodiments, administration of a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises administering a rigid gob or dorsal lipectomy procedure Reduce one or more adverse symptoms associated with (eg, scarring, joint stiffness, swelling, inflammation, and pain).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein has one or more symptoms associated with osteophytes (eg, scar, Used to treat joint stiffness, swelling, inflammation, and pain).

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to inhibit bone resorption in an individual. In some embodiments, the individual suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is injected into the joint. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is in contact with bone (eg, by using a wound dressing or bandage). In some embodiments, the pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 coats a bone stent, bone implant, or artificial bone (eg, an osseointegrated implant). As used herein, “Osseointegrated implant” means a three-dimensional implant that includes a hole through which osteoblasts and supporting connective tissue travel. In some embodiments, the bone stent is inserted into the intramedullary canal of the bone. In some embodiments, the bone stent is placed in the tarsal sinus. In some embodiments, the bone stent was placed on the knee or joint. In some embodiments, the bone stent is placed at the fracture site. In some embodiments, the bone stent is expandable and contractible.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to promote or induce bone formation in an individual. . In some embodiments, the individual suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is injected into the joint. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is in contact with bone (eg, by using a wound dressing or bandage). In some embodiments, the pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 coats a bone stent, bone implant, or artificial bone (eg, an osseointegrated implant). As used herein, “Osseointegrated implant” means a three-dimensional implant that includes a hole through which osteoblasts and supporting connective tissue travel. In some embodiments, the bone stent is inserted into the intramedullary canal of the bone. In some embodiments, the bone stent is placed in the tarsal sinus. In some embodiments, the bone stent was placed on the knee or joint. In some embodiments, the bone stent is placed at the fracture site. In some embodiments, the bone stent is expandable and contractible.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to inhibit osteoclast differentiation. In some embodiments, the individual suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is injected into the joint. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is in contact with bone (eg, by using a wound dressing or bandage). In some embodiments, the pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 coats a bone stent, bone implant, or artificial bone (eg, an osseointegrated implant). As used herein, “Osseointegrated implant” means a three-dimensional implant that includes a hole through which osteoblasts and supporting connective tissue travel. In some embodiments, the bone stent is inserted into the intramedullary canal of the bone. In some embodiments, the bone stent is placed in the tarsal sinus. In some embodiments, the bone stent was placed on the knee or joint. In some embodiments, the bone stent is placed at the fracture site. In some embodiments, the bone stent is expandable and contractible.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to promote mineralization by an individual's osteoblasts. The In some embodiments, the individual suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is injected into the joint. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is in contact with bone (eg, by using a wound dressing or bandage). In some embodiments, the pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 coats a bone stent, bone implant, or artificial bone (eg, an osseointegrated implant). As used herein, “Osseointegrated implant” means a three-dimensional implant that includes a hole through which osteoblasts and supporting connective tissue travel. In some embodiments, the bone stent is inserted into the intramedullary canal of the bone. In some embodiments, the bone stent is placed in the tarsal sinus. In some embodiments, the bone stent was placed on the knee or joint. In some embodiments, the bone stent is placed at the fracture site. In some embodiments, the bone stent is expandable and contractible.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to balance an individual's bone resorption and bone formation. The In some embodiments, the individual suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or bone tumor. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is injected into the joint. In some embodiments, a pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 is in contact with bone (eg, by using a wound dressing or bandage). In some embodiments, the pharmaceutical composition comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 coats a bone stent, bone implant, or artificial bone (eg, an osseointegrated implant). As used herein, “Osseointegrated implant” means a three-dimensional implant that includes a hole through which osteoblasts and supporting connective tissue travel. In some embodiments, the bone stent is inserted into the intramedullary canal of the bone. In some embodiments, the bone stent is placed in the tarsal sinus. In some embodiments, the bone stent was placed on the knee or joint. In some embodiments, the bone stent is placed at the fracture site. In some embodiments, the bone stent is expandable and contractible.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to treat orthodontic or periodontal conditions. The In some embodiments, the periodontal condition is selected from gingivitis, gingival recession, or periodontitis. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used as an anti-inflammatory agent, or bone binding or healing. Used to prompt. In some embodiments, a pharmaceutical composition comprising the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein to promote implant bone bonding, anti-inflammatory, and healing. Is used in combination with dental implants.

  In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein treats hoarseness or voicing disorders. In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is to be injected for laryngeal surgery to repair the vocal cords. used.

In some embodiments, a pharmaceutical composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is coated on a medical implant (eg, a stent).
In some embodiments, the medical graft / nHC-HA / PTX3 or graft / rcHC-HA / PTX3 complex disclosed herein is infused into individual individuals and nHC-HA / PTX3. Alternatively, the rcHC-HA / PTX3 complex is partially or completely released to the individual. In some embodiments, the medical implant is a stent (eg, a bone stent or a coronary stent). In some embodiments, the medical implant is a bone stent. In some embodiments, the medical implant is a coronary stent.

  combination

  In some embodiments, the compositions and methods described herein are used with a second therapeutic agent. In some embodiments, the compositions and methods described herein are used with two or more therapeutic agents. In some embodiments, the compositions and methods described herein are used with one or more therapeutic agents. In some embodiments, the compositions and methods described herein are used with 2, 3, 4, 5, 6, 7, 8, 9, or 10 or more therapeutic agents.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second therapeutic agent are administered in the same dosage form. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second therapeutic agent are administered in separate dosage forms.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second therapeutic agent are simultaneously (eg, simultaneously, essentially simultaneous, or the same treatment). (By protocol).

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second therapeutic agent are administered sequentially. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is administered before or after the second therapeutic agent. In some embodiments, the time between administrations of the second active agent of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is the drug efficacy, solubility, bioavailability, Depending on the properties of each drug, such as plasma half-life and kinetic profile, it can vary from minutes to hours. In some embodiments, the circadian change in target molecule concentration determines the optimal dosing interval. In some embodiments, the time between administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second active agent is about 1 hour, about 2 hours, about 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 11 hours, 1 day, 2 days, 3 days, 4 days , About 5 days, about 6 days, about 1 week, about 2 weeks, about 3 weeks, about 1 month, or longer.

  In some embodiments, the co-administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein comprises the nHC-HA / PTX3 or rcHC-HA / PTX3 complex alone. A lower dose of nHC-HA / PTX3 or rcHC-HA / PTX3 complex is required than is required for administration. In some embodiments, co-administration of a second therapeutic agent requires a lower dose of the second therapeutic agent than is required when administering the second therapeutic agent alone. The Methods for experimentally determining therapeutically effective amounts of drugs and other drugs used in combination therapy regimens are known and described in the art. For example, the use of metronomic administration, ie providing more frequent and lower doses to minimize toxic side effects, has been extensively described in the art. Combination therapy further includes periodic treatments that start and stop at various times to assist in the clinical management of the individual.

  In some embodiments, a combination therapy of nHC-HA / PTX3 or rcHC-HA / PTX3 complex and one or more additional therapeutic agents is modified. In some embodiments, the combination therapy is modified, whereby the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex is increased relative to the amount of the second therapeutic agent. In some embodiments, the combination therapy is modified, whereby the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex is reduced relative to the amount of the second therapeutic agent. In some embodiments, the combination therapy is modified, whereby the amount of the second therapeutic agent is increased relative to the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the combination therapy is modified, whereby the amount of the second therapeutic agent is reduced relative to the amount of nHC-HA / PTX3 or rcHC-HA / PTX3 complex.

  In some embodiments, the second therapeutic agent is selected from cytotoxic agents, antibacterial agents, anti-angiogenic agents, chemotherapeutic agents, anti-tumor agents, or radiation therapy. In some embodiments, the second therapeutic agent is an alkylating agent, an antimetabolite, epidophyllotoxins, an antineoplastic enzyme, a topoisomerase inhibitor, procarbazine, mitoxantrone, a platinum coordination compound, Biological response modifiers and growth inhibitors, hormone / antihormonal therapeutics, hematopoietic growth factors, aromatase inhibitors, antiestrogens, antiandrogens, corticosteroids, gonadorelin agonists, microtubule active agents, nitrosoureas, lipids or protein kinases Targeted drugs, agents, immunomodulators (IMiDs), protein or lipid phosphatase targeted drugs, anti-angiogenic drugs, Akt inhibitors, IGF-I inhibitors, FGF3 modulators, mTOR inhibitors, Smac mimetics, HDAC inhibitors, Causes cell differentiation Agent, bradykinin 1 receptor antagonist, angiotensin II antagonist, cyclooxygenase inhibitor, heparanase inhibitor, lymphokine inhibitor, cytokine inhibitor, IKK inhibitor, P38 MAPK inhibitor, HSP90 inhibitor, multi-target kinase inhibitor, bisphosphonate, rapamycin derivative , Anti-apoptotic pathway inhibitor, apoptotic pathway agonist, PPAR agonist, RAR agonist, RAS isoform inhibitor, telomerase inhibitor, protease inhibitor, metalloprotease inhibitor, aminopeptidase inhibitor, SHIP activator-AQX-MN100 , Humax-CD20 (ofatumumab), CD20 antagonist, IL2-diphtheria toxin fusion, or combinations thereof It is. In some embodiments, the antimicrobial agent is an antiviral agent, an antimicrobial agent, or an antifungal agent. Typical non-limiting antibacterial agents include aminoglycosides, beta-lactams, quinolones or fluoroquinolones, macrolides, sulfonamides, sulfamethoxazoles, tetracyclines, streptogramins, oxazolidinones (such as linezolid), clinda Mycin, lincomycin, rifomycin, glycopeptide, polymyxins, lipo-peptide antibiotics, as well as pharmacologically acceptable sodium salts, pharmacologically acceptable calcium salts, pharmacologically Including those classified as acceptable potassium salts, lipid formulations, derivatives and / or analogs of the above. Non-limiting typical classifications of antifungal agents include clotrimazole, miconazole, ketoconazole, econazole, butconazole, omoconazole, oxyconazole, terconazole, itraconazole, fluconazole, voriconazole (UK109,496), posaconazole, labconazole, Or imidazole or triazole, such as flutrimazole; polyene antifungals such as amphotericin B, liposomal amphotericin B, natamycin, nystatin, and nystatin lipid preparation; caspofungin, micafungin, anidulafungin, silofungin, etc. LY, an active cyclic lipopeptide antifungal agent comprising echinocandin of LY; 21019; LY303366; terbinafine (terbinafme) include allylamine groups antifungal agents, such as. Still other non-limiting examples of antifungal agents include naphthifine, tolnaftate, mediocidin, candicidin, tricomycin, hamycin, aurefungin, ascosin, ayfatin, azacortin (Azacolutin), tricomycin, levorin, heptamycin, candymycin, griseofulvin, BF-796, MTCH 24, BTG-137586, pradimicins (MNS 18184), benamicin (ben) Mycin Z; flucytosine or perymycin. Non-limiting examples of antiviral agents include cidofovir, amantadine, rimantadine, acyclovir, ganciclovir, pencyclovir, famciclovir, foscamet, ribavirin, or valcycloclovir . In some embodiments, the antimicrobial agent is an innate immunity peptide or protein. Some typical classes of innate peptides or proteins are transferrin, lactoferrin, defensin, phospholipase, lysozyme, cathelicidin, serprocidins, bactericidal permeability increasing proteins, amphipathic alpha helical peptides, and , Other synthetic antibacterial proteins. In some embodiments, the antimicrobial agent is a preservative.

  In some embodiments, the second therapeutic agent is ARRY-797, dacarbazine (DTIC), actinomycin C2, C3, D, and F1, cyclophosphamide, melphalan, estramustine, maytansinol, Rifomycin, streptocaricin, doxorubicin, daunorubicin, epirubicin, idarubicin, detorubicin, carminomycin, esorubicin, mitoxantrone, bleomycin A, A2, and B, camptothecin, irinotecan, topotecan, 9-aminocamptothecin , 11-methylenedioxycamptothecin, 9-nitrocamptothecin, bortezomib, te Zolomide, TAS103, NPI0052, combretastatin, combretastatin A-2, combretastatin A-4, calicheamicin, neocarcinostatins, epothilone AB, C, and semisynthetic variants, Herceptin, Rituxan, CD40 antibody, asparaginase, interleukin, interferon, leuprolide and pegase pargase, 5-fluorouracil, fluorodeoxyuridine, ptorafur, 5'-deoxyfluorouridine, UFT, MITC, S-1 Capecitabine, diethylstilbestrol, tamoxifen, toremifene, tolmud ex), thymitaq, flutamide, fluoxymesterone, bicalutamide, finasteride, estradiol, trioxyphene, dexamethasone, leuprorelin acetate, estramustine, droloxifene, medroxyprogesterone, megest Roll, aminoglutethimide, test lactone, testosterone, diethylstilbestrol, hydroxyprogesterone, mitomycin A, B, and C, porphyromycin, cisplatin, carboplatin, oxaliplatin, tetraplatin, platinum-DACH, ormaplatin, thalidomide, Lenalidomide, CI-973, telomestatin, CHIR258, Rad 001, SAHA, tubacin (Tubacin 17-AAG, sorafenib, JM-216, podophyllotoxin, epipodophyllotoxin, etoposide, teniposide, tarceva, iressa, imatinib, miltefosine, perifosine, aminopterin, methotrexate, methotterin, dichloro methotrexate, 6-mercapto Purine, thioguanine, azatuoprine, allopurinol, cladribine, fludarabine, pentostatin, 2-chloroadenosine, deoxycytidine, cytosine arabinoside, cytarabine, azacitidine, 5-azacytosine, gemcitabine, 5-azacitosine, Vincristine, vinblastine, vinorelbine, leurosine, leu Selected from leucidin and vindesine, paclitaxel, taxotere, and / or docetaxel.

  In some embodiments, the second active agent is niacin, fibrate, statin, Apo-A1 mimetic polypeptide (eg, DF-4, Novartis), apoA-I transcription up-regulator, ACAT Inhibitors, CETP modifiers, glycoprotein (GP) IIb / IIIa receptor antagonists, P2Y12 receptor antagonists, Lp-PLA2 inhibitors, anti-tumor necrosis factor (TNF), interleukin-1 (IL-1) receptor antagonists , Interleukin-2 (IL-2) receptor antagonist, interleukin-6 (IL-6) receptor antagonist, interleukin-12 (IL-12) receptor antagonist, interleukin-17 (IL-17) receptor Body antagonist, inter Ikin-23 (IL-23) receptor antagonist, cytotoxic agent, antibacterial agent, immunomodulator, antibiotic, T cell costimulatory blocker, anti-rheumatic agent to alleviate disorder, B cell depleting agent, immunosuppressant, Anti-lymphocyte antibodies, alkylating agents, antimetabolites, plant alkaloids, terpenoids, topoisomerase inhibitors, anti-tumor antibiotics, monoclonal antibodies, hormone therapy (eg, aromatase inhibitors), or combinations thereof.

  In some embodiments, the second active agent is an anti-TGF-β antibody, an anti-TGF-β receptor blocking antibody, an anti-TNF antibody, an anti-TNF receptor blocking antibody, an anti-IL1β antibody, an anti-IL1β receptor blocking antibody. Anti-IL-2 antibody, anti-IL-2 receptor blocking antibody, anti-IL-6 antibody, anti-IL-6 receptor blocking antibody, anti-IL-12 antibody, anti-IL-12 receptor blocking antibody, anti-IL-17 An antibody, an anti-IL-17 receptor blocking antibody, an anti-IL-23 antibody, or an anti-IL-23 receptor blocking antibody.

In some embodiments, the second active agent is niacin, bezafibrate, ciprofibrate, clofibrate, gemfibrozil, fenofibrate, DF4; (Ac-D-WF-K-A-F-Y-D -KV-A-E-K-F-K-E-A-F-NH2) DF5; RVX-208 (Resverlogix); avasimibe; pactimibe sulfate (CS-505); CI -1011 (2,6-diisopropylphenyl [((2,4,6-triisopropylphenyl) acetyl] sulfamate)); CI-976 (2,2-dimethyl-N- (2,4,6-trimethoxyphenyl) ) Dodecanamide); VULM1457 (1- (2,6-diisopropyl-phenyl) -3- [4 (4′-nitrophenylthio) phenyl] urea); CI-976 (2,2-dimethyl-N- (2,4,6-trimethoxyphenyl) dodecanamide); E-5324 (n-butyl-N ′) -(2- (3- (5-Ethyl-4-phenyl-1H-imidazol-1-yl) propoxy) -6-methylphenyl) urea); HL-004 (N- (2,6-diisopropylphenyl) tetra Decylthioacetamide); KY-455 (N- (4,6-dimethyl-1-pentylindoline-7-yl) -2,2-dimethylpropanamide): FY-087 (N- [2- [N′- Pentyl- (6,6-dimethyl-2,4-heptadiynyl) amino] ethyl]-(2-methyl-1-naphthyl-thio) acetamide);
MCC-147 (Mitsubishi Pharma); F12511 ((S) -2 ′, 3 ′, 5′-trimethyl-4′-hydroxy-alpha-dodecylthioacetanilide); SMP-500 (Sumitomo Pharmaceuticals); CL2777082 (2,4 -Difluoro-phenyl-N [[4- (2,2-dimethylpropyl) phenyl] methyl] -N- (heptyl) urea); F-1394 ((1s, 2s) -2- [3- (2,2 -Dimethylpropyl) -3-nonylureido] aminocyclohexane-1-yl 3- [N- (2,2,5,5-tetramethyl-1,3-dioxane-4-carbonyl) amino] propionate); CP-1113818 (N- (2,4-bis (methylthio) -6-methyl) Rupyridin-3-yl) -2- (hexylthio) decanoic acid amide); YM-750; torcetrapib; anacetrapid; JTT-705 (Japan Tobacco / Roche); abciximab; eptifibatide; tirofiban; loxifiban; XV459 (N (3)-(2- (3- (4-formamidinophenyl) isoxazolin-5-yl) acetyl) -N (2)-(1-butyloxycarbonyl) -2,3- SR 121156A (3- [N- {4- [4- (aminoiminomethyl) phenyl] -1,3-thiazol-2-yl} -N- (1-carboxyl); diaminopropionate; Boxymethylpiperid-4-yl) aminolpropionic acid, trihydrochloride); FK419 ((S) -2-acetylamino-3-[(R)-[1- [3- (piperidin-4-yl) ) Propionyl] piperidin-3-ylcarbonyl] amino] propionic acid trihydrate); clopidogrel; prasugrel; cangrelor; AZD6140 (AstraZeneca); MRS 2395 (2,2-dimethyl-propionic acid 3- (2- Chloro-6-methylaminopurin-9-yl)-(2- (2,2-dimethyl-propionyloxymethyl) -propyl ester); Bx 667 (Berlex Biosciences); Bx 048 (Berlex Biosciences); Dalapradiv (SB 480848) SB; 345495 (GlaxoSmithKline); SB-222657 (GlaxoSmithKline); Taclonex, betamethasone, tazarotene, chloroquine hydroxide, sulfasalazine, etanercept, adalimumab, infliximab, abatacept, rituximab, trastuzumab, anti-CD45 monoclonal antibody AHN-12, iodine-131 anti-B1 antibody (Corixa Corp. ), Anti-CD66 monoclonal antibody BW 250/183 (NCI, Southampton General Hospital), anti-CD45 monoclonal antibody (NCI, Baylor College Medicine), antibody anti-anb3 integrin (NCI), BIW-8962 (BioWa Inc.), antibody BC8. NCI), antibody muJ591 (NCI), indium In 111 monoclonal antibody MN-14 (NCI), yttrium Y 90 monoclonal antibody MN-14 (NCI), F105 monoclonal antibody (NIAID), monoclonal antibody RAV12 (Raven Biotechnologies), CAT- 192 (human anti-TGF-Beta1 monoclonal antibody, Genzyme), antibody 3F8 (NCI ) 177Lu-J591 (Weill Medical College of Cornell University), TB-403 (BioInvent International AB)), Anakinra, Azathioprine, Cyclophosphamide, Cyclosporine A, Leflunomide, Tri-Pentyllamin Mustard, Plasterone, LJP 394 (abetimassodium), LJP1082 (La Jolla Pharmaceutical), eculizumab, belimumab (ribamub), rhuCD40L (NIAID), eprazuzumab, sirolimus, tacrolimus, tacrolimus, tacrolimus, tacrolimus gam, Pharmacia Upjohn), anti-thymocyte globulin-rabbit (thymoglobulin, Genzyme), muromonab-CD3 (FDA Office of Orphan Products Development), basiliximab, daclizumabine, beta-linterzulbine , Tizanidine, baclofen, mesalazine, asacol, pentasa, mesalamine, balsalazide, olsalazine, 6-mercaptopurine, AIN457 (anti-IL-17 monoclonal antibody, Novartis), theophylline, D2E7 (human anti-TNF mAb polymab from Knoll Pharmaceuticals) Anti-IL-5 antibody, SB 24056 ), Kanakinumab (anti-IL-1 beta antibody, NIAMS), anti-IL-2 receptor antibody (daclizumab, NHLBI), CNTO 328 (anti-IL-6 monoclonal antibody, Centocor), ACZ885 (fully human anti-interleukin) -1 beta monoclonal antibody, Novartis), CNTO1275 (fully human anti-IL-12 monoclonal antibody, Centocor), (3S) -N-hydroxy-4-({4-[(4-hydroxy-2-butynyl) oxy ] Phenyl} sulfonyl) -2,2-dimeth-hyl-3-thiomorpholinecarboxamide (aplatatastat), golimumab (CNTO 148), onercept, BG9924 (Biogen Idec), Celto Zumabupegoru (CDP870, UCB Pharma), AZD9056 (AstraZeneca), AZD5069 (AstraZeneca), AZD9668 (AstraZeneca), AZD7928 (AstraZeneca), AZD2914 (AstraZeneca), AZD6067 (AstraZeneca), AZD3342 (AstraZeneca), AZD8309 (AstraZeneca), [( 1R) -3-methyl-1-({(2S) -3-phenyl-2-[(pyrazin-2-ylcarbonyl) amino] propanoyl} amino) butyl] boronic acid (bortezomib), AMG-714 (Anti-IL15 human monoclonal antibody, Amgen), ABT-874 (Anti-IL-12 monochrome) Antibody, Abbott Labs), MRA (tocilizumab, anti-IL-6 receptor monoclonal antibody, Chugai Pharmaceutical), CAT-354 (human anti-interleukin 13 monoclonal antibody, Cambridge Antibody Technology, MedImmulin acid, MedImmulin acid) Choline magnesium salicylate, choline salicylate, choline magnesium salicylate, choline salicylate, magnesium salicylate, sodium salicylate, diflunisal, capprofen, fenoprofen, calcium fenoprofen, flurobiprofen, ibuprofen, ketoprofen, nabutone, Ketorolac rac), ketorolac tromethamine, naproxen, oxaprozin, diclofenac, etodolac, indomethacin, sulindac, tolmethine, meclofenamate, meclofenamate sodium, mefenamic acid, piroxicam, meloxicam, celecoxib, celecoxib, CS-502 (Sankyo), JTE-522 (Japan Tobacco Inc.). ), L-745, 337 (Almirall), NS398 (Sigma), betamethasone (Celestone), prednisone (althamethasone), aldosterone, amsinonide, beclomethasone, betamethasone, budesonide, clotresonol, clobetasol, clobetasol Cortisone, Cortibazole, Deflazacoat, Deoxycorticosterone, Desonide, Desoxymethazone, Desoxycorton, Dexamethasone, Diflorazone, Diflucortron, Difluprednate, Fluchlorolone, Fludrocortisone, Fludroxycortide, Flumethasone, Flunisolide, Full Osinolone acetonide, fluocinonide, fluocortin, fluocortron, fluo Metron, fluperolone, flupredidene, fluticasone, formocortal, formoterol, halcinonide, halometasone, hydrocortisone, hydrocortisone aceponate, hydrocortisone butylate, hydrocortisone butteprate Prednisolone, methylprednisolone aceponate, mometasone furancarboxylate, parameterzone, predniscarbate, prednisone, rimexolone, thixocortol, triamcinolone, urobetasol Cisplatin, carboplatin, oxaliplatin, mechloretamine; cyclophosphamide, chlorambucil, vincristine; vinblastine, vinorelbine; vindesine, azathioprine; mercaptopurine, fludarabine; pentostatin, cladribine, 5-fluorouracil (5FU); floxuridine (FUDR); Cytosine arabinoside; methotrexate, trimethoprim; pyrimethamine; pemetrexed; paclitaxel, docetaxel, etoposide, teniposide, irinotecan; topotecan; amsacrine, etoposide, etoposide phosphate, teniposide, dactinubicin r idarubicine); Epirubici Bleomycin, pricamycin, mitomycin; trastuzumab, cetuximab, rituximab, bevacizumab, finasteride; goserelin; aminoglutethimide, anastrozole, letrozole, borozole, exemestane, 4-androstene-3,6,17-trione (" 6-oxo "); 1,4,6-androstatriene-3,17-dione (ATD); formestane; test lactone, fadrozole; or combinations thereof.

  In some embodiments, the second therapeutic agent is an antibiotic. In some embodiments, the second therapeutic agent is an antibacterial agent. In some embodiments, the second therapeutic agent is amikacin, gentamicin, kanamycin, neomycin, netilmycin, streptomycin, tobramycin, paromomycin, geldanamycin, herbimycin, loracarbef, ertapenem, doripenem, imipenem, silastatin, meropenem, cefadroxyl , Cefazolin, cephalothin, cephalexin, cefaclor, cefamandol, cefoxitin, cefprozil, cefuroxime, cefixime, cefdinir, cefditoren, cefoperazone, cefotaxime, cefpodoxime, ceftazidime, ceftoxibutef , Teicoplanin, Vancomycin, Azithromycin, Clarisroma Syn, dirithromycin, erythromycin, roxithromycin, troleandomycin, tethromycin, spectinomycin, aztreonam, amoxicillin, ampicillin, azulocillin, carbenicillin, cloxacillin, dicloxacillin, flucloxacillin, mezlocillin, methicillin, nafcillin, nafcillin , Penicillin, piperacillin, ticarcillin, bacitracin, colistin, polymyxin B, ciprofloxacin, enoxacin, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin, norfloxacin, ofloxacin, trovafloxacin, mafenid Sulfacetamide, sulfamethizole, sulfanimilimide (su fanimilimde), sulfasalazine, sulfisoxazole, trimethoprim, demeclocycline, doxycycline, minocycline, oxytetracycline, cloframine, chloramphenomycin , Ethambutol, fosfomycin, fusidic acid, furazolidone, isoniazid, linezolid, metronidazole, mupirocin, nitrofurantoin, platensimimycin, pyrazinamide, quinuspristin / dalfopristin, rifampin, tinidazole, and combinations thereof.

  In some embodiments, the second therapeutic agent is an antiviral agent. In some embodiments, the second therapeutic agent is acyclovir, famciclovir, valacyclovir, abacavir, acyclovir, adefovir (adfovir), amantadine, amprenavir, arbidol, atazanavir, atripla (artipla), Bribdin, Cidofovir, Combivir, Eduxudine, Efavirenz, Emtricitabine, Enfuvirtide, Entecavir, Fomivirsen, Fosamprenavir, Foscarnet, Phosphonet, Ganciclovir, Gardasil, Ivacitabine, Imunovir, Immodovir Indinavir, inosine, integrase inhibitor, interferon type I (eg, IFNα and IFNβ), interferon Ron type II, including interferon type III, interferon, lamivudine, lopinavir, loviride, MK-0518, maraviroc, moroxidine, nelfinavir, nevirapine, nexavir, nucleoside analog, oseltamivir, pencycloprevir, penciclovir, penciclovir, Dofilotoxin, protease inhibitor, reverse transcriptase inhibitor, ribavirin, rimantadine, ritonavir, saquinavir, stavudine, tenofovir, tenofovir disoproxil, tipranavir, trifluridine, tridivir, tromantadine, trubada, valganciclovir, bicrivirok Viramidine, Sarcitabine, Zanamivir, Zidov Emissions, and is this combination.

  In some embodiments, the second therapeutic agent is an antifungal agent. In some embodiments, the second therapeutic agent is amorolfine, butenafine, naphthifine, terbinafine, flucytosine, fluconazole, itraconazole, ketoconazole, posaconazole, rubconazole, voriconazole, clotrimazole, econazole, Oxyconazole, sulconazole, terconazole, thioconazole, nikkomycin Z, caspofungin, micafungin, anidurafungin, amphotericin B, liposomal nystatin, pimaricin, griseofulvin, ciclopirox olamine, haloprozine, tolnaftate, undecylenate Clioquinol and combinations thereof.

  In some embodiments, the second therapeutic agent is an antiparasitic agent. In some embodiments, the second therapeutic agent is amitraz, amoscanate, avermectin, carbadox, diethylcarbamazine, dimethridazole, diminazen, ivermectin, macrofilariside, malathion, mitavan, Oxamniquin, permethrin, praziquantel, pyrantel pamoate, selamectin, sodium stibogluconate, thiabendazole, and combinations thereof.

  Combination using cells and tissues

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with a cell, a plurality of cells, or a tissue.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with therapeutic cells. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with a tissue graft. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with stem cell transplantation. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with an organ transplant.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein can be combined with tissue transplantation (eg, simultaneously, essentially simultaneously, or in the same treatment protocol). ) To be administered. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are administered before and after tissue transplantation. In some embodiments, the time between administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the tissue graft is equal to the efficacy, solubility, bioavailability, plasma half of the drug. Depending on the properties of each drug, such as the phase and kinetic profile, it can range from minutes to hours. In some embodiments, the circadian change in target molecule concentration determines the optimal dosing interval. In some embodiments, the time between administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein and the second active agent is less than about 1 hour, less than 1 day, Less than one week or less than one month.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with a tissue transplant and an immunosuppressive agent. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is a tissue transplantation and calcineurin inhibitor (eg, cyclosporine or tacrolimus); an mTOR inhibitor (sirolimus; Anti-proliferative drugs (azathiopurine or mycophenolic acid); corticosteroids (eg prednisolone or hydrocortisone); monoclonal anti-IL-2Rα receptor antibodies (eg basiliximab or daclizumab); polyclonal anti-T cells; An antibody (eg, anti-thymocyte globulin (ATG) or anti-lymphocyte globulin (ALG)); or a combination thereof is co-administered.

  In some embodiments, the tissue is covered with a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the plurality of stem cells is covered with a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the organ is covered with a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, covering the tissue with nHC-HA / PTX3 or covering the tissue with the rcHC-HA / PTX3 complex disclosed herein prevents it from being affected by the host immune system.

  In some embodiments, the organ, tissue, or cells are contacted with an nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the organ, tissue, or cells are contacted with a composition comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the composition has a pH of about 7.0 to about 7.5. In some embodiments, the composition has a pH of 7.4. In some embodiments, the composition comprises potassium, magnesium, and raffinose. In some embodiments, the composition further comprises at least one of adenosine, glutathione, allopurinol, and hydroxyethyl starch. In some embodiments, the composition is a UW solution supplemented with the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein.

  In some embodiments, the organ, tissue, or cells are about 30 minutes, about 1 hour, about 1 hour, with the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. Contact for 2 hours, about 3 hours, about 4 hours, about 5 hours, about 6 hours, about 12 hours, about 24 hours, about 36 hours, or about 48 hours. In some embodiments, contact occurs at a temperature that protects tissue and vascular conditioning (eg, below ambient temperature). In some embodiments, the conditioning is 4 ° C.

  Medical device combination

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes disclosed herein are co-administered with a medical device. In some embodiments, the medical device or a portion thereof contacts the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein is used to cover a medical device or a portion thereof as described elsewhere herein. . In some embodiments, administration of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein in combination with a medical device reduces and inhibits an inflammatory response to the implanted medical device. Or prevent. In some embodiments, administration of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex disclosed herein in combination with a medical device comprises growth of microorganisms on the implanted medical device (ie, Reduce, inhibit or prevent the formation of infectious biofilms produced by long-term biofilm infections). A typical such biofilm is produced by bacteria such as, but not limited to, S. aureus.

  Products and kits

  The products provided herein include packaging materials. Packaging materials used in packaging pharmaceutical products are well known to those skilled in the art. Examples of pharmaceutical packaging materials include, but are not limited to, blister packs, bottles, tubes, inhalers (eg, pressurized metered dose inhalers (MDI), dry powder inhalers (DPI), nebulizers (eg, jet or Ultrasonic nebulizers) and other single breathing fluid systems), pumps, bags, vials, containers, syringes, bottles, and any packaging material suitable for the selected formulation and desired administration and treatment It is done. In some embodiments, the pharmaceutical composition is incorporated into, applied to, and coated on a medical device such as an implant, catheter, artificial joint, stent, valve, nanoparticle, or microcapsule.

  In some embodiments, a pharmaceutical composition or pharmaceutical formulation described herein is provided as a kit. The kit optionally implements instructions, equipment, and additional reagents (eg, sterile water or saline for dilution of the composition and / or reconstitution of lyophilized protein), and methods Including one or more components such as tubes, containers, and syringe components. Exemplary kits include a pharmaceutical composition or pharmaceutical formulation provided herein, and optionally instructions for use, a device for administering the pharmaceutical composition or pharmaceutical formulation to a subject, a subject's a device for detecting a complex of nHC-HA / PTX3 or rcHC-HA / PTX3, a device for detecting a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 in a sample obtained from a subject, And a device for administering an additional therapeutic agent to the subject.

  The kit can optionally include instructions for use. The instructions will typically include nHC-HA / PTX3 or rcHC-HA / PTX3 complexes, and optionally other components included in the kit, and the appropriate state of the subject, appropriate administration Included are substantial representations describing the method of administration, including the amount, dosing regimen, and appropriate method of administration to administer the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, the instructions include guidance for monitoring the subject over the duration of the treatment time.

  In some embodiments, the kit also includes a pharmaceutical composition described herein and a diagnostic item. For example, such a kit includes an item for measuring the concentration, amount, or activity of a selected nHC-HA / PTX3 or rcHC-HA / PTX3 complex in a subject.

  In some embodiments, the kits provided herein include a device for administering an nHC-HA / PTX3 or rcHC-HA / PTX3 complex to a subject. In some embodiments, any of a variety of devices known in the art for administering drugs to a subject are included in the kits provided herein. Typical devices include, but are not limited to, inhalers (eg, pressurized metered dose inhalers (MDI), dry powder inhalers (DPI), nebulizers (eg, jet or ultrasonic nebulizers), and other simple devices. Fluid respiration systems), hypodermic needles, intravenous needles, catheters, and liquid dispensers such as eye drops. Typically, a device for administering nHC-HA / PTX3 or a kit's rcHC-HA / PTX3 complex is compatible with the desired method of administration of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. .

  Expansion of stem cell culture

  In certain embodiments, disclosed herein are methods of growing isolated stem cells on a substrate comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex provided herein. As described herein, HC-HA / PTX3 complexes promote stem cell aggregation, prevent cell differentiation, and preserve stem cell marker expression.

  In some embodiments, expansion of the nHC-HA / PTX3 complex or the rcHC-HA / PTX3 complex is an embryonic stem cell (ESC) marker (eg, Oct4, Nanog, Sox2 (SRY (sex determining region Y) − Box 2), Rex1 (Zfp42), SSEA4 (stage specific embryonic antigen-4), MYC / c-Myc, and KLF4, pericyte markers (eg, NG2 (neuronal glial antigen 2 / chondroitin sulfate proteoglycan) 4 (CSPG4)), PDGFR-β (platelet-derived growth factor receptor B), and α-SMA (α-smooth muscle actin), and angiogenic markers (eg, CD133 / 2, FLK-1 (VEGF-) R2, Ly-73), vWF (von Willebrand factor), CD34, CD31 (PECA -1) and one or more expression of CD 146. In some embodiments, expression of stem cell markers is performed using conventional methods, eg, protein expression analysis (eg, Western blot, immunofluorescence, Measured by histochemical examination, fluorescence activated cell sorting) or mRNA analysis (eg, polymerase chain reaction (PCR) or Northern).

  In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 inhibits TGF-β signaling in cultured cells. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 suppresses TGF-β signaling in cultured stem cells. In some embodiments, inhibition of TGF-β signaling is reduced by nHC-HA / PTX3 or rcHC-HA / PTX3 as compared to absence of nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Refers to a decrease in the activity or expression of one or more proteins or markers in a TGF-β cell signaling pathway, such as pSMAD2 / 3 signaling in a cell, or in alpha smooth muscle formation in the presence of a complex. .

  In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 causes BMP signaling in cultured cells. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 causes BMP signaling in cultured stem cells. In some embodiments, inhibition of TGF-β signaling is reduced by nHC-HA / PTX3 or rcHC-HA / PTX3 as compared to absence of nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Increased activity or expression of one or more proteins in a BMP signaling pathway such as BMP-2, BMP-4, BMP-6, and pSMAD1 / 5/8 in the presence of the complex Point to.

  In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are embryonic stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are adult stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are fetal stem cells. In some embodiments, the isolated stem cell cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 is an induced pluripotent / progenitor stem cell (iPSC).

In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are mesenchymal stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are adipose stem cells (ASC). In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are umbilical cord stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are amniotic stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are each membranous cell, such as limbal niche cell or limbal epithelial progenitor cell. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are endothelial stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are hematopoietic stem cells. In some embodiments, the isolated stem cell is a bone marrow stem cell. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are neural stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are endothelial progenitor cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are skeletal muscle stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are breast stem cells. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are intestinal stem cells.
In some embodiments, the isolated stem cell cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 is an induced pluripotent / progenitor stem cell (iPSC). In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are induced pluripotent stem cells derived from differentiated or partially differentiated cells of the organism. is there. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are induced pluripotent stem cells derived from fibroblasts. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are induced pluripotent stem cells derived from human corneal fibroblasts.

  In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are fetal tissue derived from placental tissue or umbilical cord tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from amniotic membrane. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from adipose tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from limbal tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from bone marrow. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from endothelial tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from limbal tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from neural tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from limbal tissue. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from skeletal muscle. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from skin. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from the digestive system. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from the pancreas. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from the liver. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from the olfactory mucosa. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from a germ cell population. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from blood. In some embodiments, the isolated stem cells cultured on nHC-HA / PTX3 or rcHC-HA / PTX3 are derived from umbilical cord blood.

  In some embodiments, the HC-HA / PTX3 complex is nHC-HA / PTX3 isolated from amniotic membrane or umbilical cord. In some embodiments, the HC-HA / PTX3 complex is a reconstituted HC-HA complex. In some embodiments, HA is covalently bound to HC. In some embodiments, the IαI HC is heavy chain 1 (HC1). In some embodiments, the HC-HA complex comprises pentraxin 3 (PTX3).

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises a small leucine-rich proteoglycan (SLRP). In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises a Type I, Type II, or Type III SLRP. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex comprises PTX3 and a small leucine-rich proteoglycan (SLRP). In some embodiments, the small leucine-rich proteoglycan is selected among type I SLRPs, such as decorin and biglycan. In some embodiments, the small leucine-rich proteoglycan is a type II SLRP such as fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, and osteoadherin. It is selected from the inside. In some embodiments, the small leucine-rich proteoglycan is selected among type III SLRPs such as epipican and osteoglycin.

  In some embodiments, the isolated stem cells are grown on a substrate comprising immobilized nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the immobilized nHC-HA / PTX3 or rcHC-HA / PTX3 comprises one or more small leucine-rich proteoglycans (SLRP). In some embodiments, the SLRP is selected from among bikunin, decorin, biglycan, and osteoadherin. In some embodiments, the small leucine-rich protein comprises a glycosaminoglycan. In some embodiments, the small leucine-rich proteoglycan comprises keratan sulfate.

  In some embodiments, the isolated stem cells are grown in a medium comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In some embodiments, nHC-HA / PTX3 or rcHC-HA / PTX3 comprises one or more small leucine-rich proteoglycans (SLRP). In some embodiments, the SLRP is selected from among bikunin, decorin, biglycan, and osteoadherin. In some embodiments, the small leucine-rich protein comprises a glycosaminoglycan. In some embodiments, the small leucine-rich proteoglycan comprises keratan sulfate. In some embodiments, the medium is embryonic stem cell medium, modified embryonic stem cell medium, supplemented hormone epithelial medium, and / or combinations thereof. In some embodiments, the media is supplemented with one or more growth factors. In some embodiments, the media is supplemented with EGF, bFGF, and / or LIF. In some embodiments, the medium is supplemented with inhibitors of Rho-related kinases (ROCK inhibitors).

  Induction and maintenance of pluripotency

  In certain embodiments, methods of inducing cellular pluripotency or maintaining stem cell pluripotency on a substrate comprising a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 are provided herein. It is disclosed in the document. As described herein, the HC-HA / PTX3 complex helps maintain stem cell marker expression and prevents cell differentiation throughout the continuous pathway of the stem cell population. In addition, as described herein, the HC-HA / PTX3 complex facilitates the induction of stem cell properties in differentiated or partially segmented cell populations.

  In certain embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex promotes or induces pluripotency in differentiated or partially cell. In certain embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is a differentiated or partially differentiated cell cultured in the absence of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Compared to, it promotes or induces pluripotency of differentiated or partially cell. In a typical method, differentiated or partially fractionated cells are cultured on a substrate comprising a nHC-HA / PTX3 or rcHC-HA / PTX3 complex, whereby pluripotency is induced intracellularly. .

  In certain embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex promotes or induces pluripotency of stem cells. In certain embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is compared to a stem cell cultured in the absence of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Promotes or induces pluripotency. In a typical method, stem cells are cultured on a substrate containing a complex of nHC-HA / PTX3 or rcHC-HA / PTX3, thereby maintaining pluripotency within the stem cells. In a typical method, stem cells are cultured on a substrate containing the nHC-HA / PTX3 or rcHC-HA / PTX3 complex, whereby pluripotency is induced in the stem cells.

  Using gene reprogramming with protein transcription factors, pluripotent stem cells comparable to embryonic stem cells were obtained from human adult skin tissue. iPSC cells are generally obtained by introducing a specific stem cell-associated gene into non-pluripotent cells such as adult fibroblasts. Gene transfer is generally accomplished by a viral vector such as a retrovirus in which the pluripotency gene is operably linked to a promoter for gene expression. The four important pluripotency genes essential for the production of pluripotent stem cells are Oct-3 / 4 (Pou5f1), Sox2, c-Myc, and Klf4. Other genes can increase the efficiency of induction. In some studies, Oct4, Sox2, Nanog, and Lin28 have been used to induce pluripotency. In certain instances, after 3-4 weeks, a small number of transfected cells began to become morphologically and biochemically similar to pluripotent stem cells, and morphological selection, doubling It is generally isolated by time or by selection of reporter gene and antibiotic.

  In some embodiments, differentiated or partially differentiated cells using fewer than four heterologous expressions of the essential transcription factors OCt-3 / 4 (Pou5f1), Sox2, c-Myc, and Klf4 Methods for inducing pluripotency of are provided. In some embodiments, a method for inducing pluripotency is provided, wherein the use of a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 comprises OCt-3 / 4 ( Pu5f1), Sox2, c-Myc, and enhances the induction of pluripotency in differentiated or partially differentiated cells expressing at least one of Klf4. In some embodiments, a method for inducing pluripotency is provided, wherein the use of a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 comprises OCt-3 / 4 ( Pu5f1), Sox2, c-Myc, and Klf4 enhances the induction of pluripotency in differentiated or partially cell expressing one, two or three factors selected from Klf4. In some embodiments, a method for inducing pluripotency is provided, wherein the use of a complex of nHC-HA / PTX3 or rcHC-HA / PTX3 comprises OCt-3 / 4 ( Increases the induction of pluripotency in differentiated or partially differentiated cells expressing Pou5f1). In some embodiments, a method for inducing pluripotency is provided, wherein the use of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex differentiated to express Sox2 by introduction of a heterologous gene Or enhance the induction of pluripotency in a parted cell. In some embodiments, a method for inducing pluripotency is provided, wherein use of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex expresses c-Myc by introduction of a heterologous gene Increases induction of pluripotency in differentiated or partially cell. In some embodiments, a method for inducing pluripotency is provided, wherein the use of a nHC-HA / PTX3 or rcHC-HA / PTX3 complex differentiated to express Klf4 by introduction of a heterologous gene. Or enhance the induction of pluripotency in a parted cell.

  In some embodiments, the differentiated or partially cell is transduced to express one or more of Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4, and The introduced cells are cultured on a substrate containing a complex of nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the differentiated or partially cell is transduced to express at least one of Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4, and The introduced cells are cultured on a substrate containing a complex of nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the differentiated or partially segmented cell is for expressing one, two, or three of Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4. Transduced and transduced cells are cultured on a substrate containing nHC-HA / PTX3 or rcHC-HA / PTX3 complexes. In some embodiments, the differentiated or partialized cells are transduced to express Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4, and the transduced cells Is cultured on a substrate containing a complex of nHC-HA / PTX3 or rcHC-HA / PTX3. In some embodiments, the differentiated or partially cell is transduced to express Oct-3 / 4 (Pou5f1), and the transduced cell is nHC-HA / PTX3 or rcHC- Incubate on substrate containing HA / PTX3 complex. In some embodiments, the differentiated or partially differentiated cell is transduced to express SOX2, and the transduced cell contains nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Incubate on containing substrate. In some embodiments, the differentiated or partially cell is transduced to express c-Myc, and the transduced cell is a nHC-HA / PTX3 or rcHC-HA / PTX3 complex. It is cultured on a substrate containing the body. In some embodiments, the differentiated or partially differentiated cell is transduced to express Klf4, and the transduced cell contains the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Incubate on containing substrate. In some embodiments, the cells are transduced to express one or more additional genes such as, for example, Nanog, Fbx15, ERas, ECAT15-2, Tcl1, and β-catenin.

  In some embodiments, the differentiated or partially differentiated cell is a viral gene comprising one or more genes encoding one or more of Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4. Transduced with vector. In some embodiments, the differentiated or partially segmented cell comprises two or more comprising one or more genes encoding one or more of Oct-3 / 4 (Pou5f1), SOX2, c-Myc, and Klf4 Transduced with the viral vector

  Various methods for induction, culturing and maintaining induced pluripotent stem cells, and evaluating stem cell markers and pluripotency of induced stem cells, including induction of various cell lines, are well known in the art. For example, U.S. Patent Nos. 7,682,828, 8,048,999, 8,211,697, 7,951,592, and U.S. Patent Publication Nos. 2009/0191159 and 2010/000375. Including the method described in.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex is a transduced cell cultured in the absence of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. In comparison, the time taken to induce pluripotency of the transduced cells is reduced. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex was transduced in the absence of the nHC-HA / PTX3 or rcHC-HA / PTX3 complex. Compared to cells, pluripotency is present in a population of transduced cells compared to transduced cells cultured in the absence of nHC-HA / PTX3 or rcHC-HA / PTX3 complexes. Increase the percentage of transduced cells induced. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex enhances the value of pluripotency in the transduced cell. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex reduces the number of heterologous transcription factors required for induction of pluripotency in the transduced cell.

  In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein inhibit TGFβ1 signaling of differentiated cells, stem cells, or iPSCs. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein inhibit SMAD2 or SMAD3 nuclear translocation of differentiated cells, stem cells, or iPSCs. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein inhibit alpha smooth muscle actin formation of differentiated cells, stem cells, or iPSCs. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein activate BMP4 signaling in differentiated cells, stem cells, or iPSCs. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complexes provided herein activate BMP6 signaling in differentiated cells, stem cells, or iPSCs. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex provided herein induces expression of differentiated cell, stem cell, or iPSC germ cell markers. In some embodiments, the nHC-HA / PTX3 or rcHC-HA / PTX3 complex provided herein is a differentiated cell, stem cell, or iPSC c-myc, KLF-4, Nanog, nestin. , Oct4, Rex-1, Sox-2, and SSEA-4 expression.

The following examples are included for illustrative purposes only and are not intended to limit the scope of what is claimed.
Example 1. Purification of native HC-HA / PTX3 (nHC-ha / PTX3) complex from human amnion extract (AME)

  Preparation of amniotic membrane extract (AME) and AM powder (AMP)

  Frozen human AM obtained from Bio-tissue (Miami, FL) was washed 2-3 times with PBS to remove the storage medium. To prepare the AME, AM was transferred to a sterile 50 ml centrifuge tube and centrifuged at 5000 g for 5 minutes at 4 ° C. to remove excess fluid. Weigh AM (-10 mg / cm 2) and transfer to a 100 mm or 150 mm sterile petri dish. Cut into small pieces with a disposable scalpel and freeze in the air phase of a liquid nitrogen container for 20 minutes before homogenizing with Tissue-Tearor (Biospec Products, Inc., Bartlesville, Okla.) In PBS. The homogenate was mixed for 30 minutes at 4 ° C. and centrifuged at 48,000 g for 30 minutes. The supernatant was collected and designated AME and used to purify nHC-HA / PTX3 or stored at -80 ° C.

  To prepare lyophilized AM powder (AMP), AM frozen in a −80 ° C. freezer was transferred to a bench top freeze dryer for 16 hours (Freezone 4.5, Labconco, KS). Lyophilized. The lyophilized AM was then micronized into its matrix shape (AMP) with Mixer Mill (Retsch, Newtown, Pa.). AMP was stored at -20 ° C or lower for further analysis.

  Purification of native HC-HA / PTX3 (nHC-HA / PTX3) complex

  AME was dissolved in a CsCl / 4M guanidine HCl mixture at an initial density of 1.35 g / ml and centrifuged at 125,000 g for 48 hours at 15 ° C. A total of 15 fractions (0.8 ml / fraction) were collected from the top and bottom of each tube. The total protein concentration of each fraction was measured with a BCA protein assay kit. The hyaluronan (HA) concentration of each fraction was measured by an ELISA-based HA quantitative test kit from Corgenix (Westminster, CO) (FIG. 1A). Fraction # 8-15 with HA but no detectable protein was pooled and used for the second ultracentrifugation. A sample of the pooled fraction (initially designated AM) was saved for analysis. Pooled fractions were adjusted with CsCl / 4M guanidine HCl at an initial density of 1.40 g / ml, centrifuged, and fractionated in the same manner as described above (FIG. 1B). Fraction # 3-15 containing HA but no detectable protein was pooled (referred to as second AM) and dialyzed against distilled water to remove CsCl and guanidine HCl. The dialysate was lyophilized in the same manner as above for AMP. Alternatively, the dialysate was mixed with 3 volumes of 95% (v / v) ethanol containing 1.3% (w / v) potassium acetate at 0 ° C. for 1 hour. After centrifugation at 15,000 g, the pellet was washed with 70% (v / v) ethanol and centrifuged again. The pellets were lightly air dried and stored at -80 ° C. The powder and pellet were called nHC-HA / PTX3 complex.

  In some examples, pooled samples were subjected to 3 or 4 ultracentrifugations. In these ultracentrifuges, only fraction # 7-12 was pooled. The initial density of CsCl / 4M guanidine HCl is 1.42 g / ml. After 3 or 4 ultracentrifugation, pooled fractions # 7-12 are referred to as nHC-HA / PTX3 (third) or nHC-HA / PTX3 (fourth).

  Pooled fractions of AME after the first, second, third, or fourth ultracentrifugation were treated with or without 0.05 N NaOH at 25 ° C. for 1 hour. Fractions pooled from the first, second, third or fourth ultracentrifugation were digested with 20 units / ml hyaluronidase (HAase) (Seikagaku Biobusiness Corporation, Tokyo, Japan) for 2 hours at 60 ° C. did.

  Samples from pooled fractions and samples treated with NaOH and HAase are then placed on a 0.5% agarose gel and stained by Stains-all staining (FIG. 1C) or by IαI heavy chain 1 (HC1 ) (FIGS. 1D and 1F), Pentraxin 3 (PTX3) (FIGS. 1E and 1G), IαI heavy chain 2 (HC2) (FIG. 1H), IαI heavy chain 3 (HC3) (FIG. 1I), bikunin (FIG. 1J), Western using antibodies to TNF-stimulated gene 6 (TSG-6) (FIG. 1K), thrombospondin-1 (TSP-1) (FIG. 1L), or IGFBP 1-3 and PF4 (FIG. 1M) Of these, the latter two were analyzed by blots, human angiogenesis arrays, each containing 56 different angiogenic proteins. R & D Systems, Minneapolis, MN) and analyzed using a protein dot assay. Briefly, 1.5 ml of human AM extract (25 μg / ml HA) and purified nHC-HA / PTX3 (second) (25 μg / ml HA) were placed on the membrane overnight at 4 ° C. Incubated separately from the pre-coated detection antibody, followed by incubation with the second antibody. The signal was detected with chemiluminescent light exposed to the X-ray film. The array data on the developed X-ray film was quantified by scanning the film with a transfer-type scanner, and the array image file was analyzed by ImageJ1.46 software (National Institutes of Health, Bethesda, MD).

  According to biochemical characterization, nHC-HA / PTX3 is composed of high molecular weight HA (HMW HA) (FIG. 1C) covalently bound to heavy chain 1 (HC1) of IαI and PTX3. Both HC1 and PTX3 in nHC-HA / PTX3 are released only after treatment with hyaluronidase (HAase) or NaOH (FIG. 1DG) and HC1 is bound to HA by an ester bond as reported. Prove that.

  In contrast, nHC-HA / PTX3 is HC2 (FIG. 1H), HC3 (FIG. 11, the band up to 12 kDa detected only after NaOH treatment is likely non-specific), bikunin (FIG. 1J), TSG-6 (FIG. 1K), and TSP-1 (FIG. 1L) are not included. Insulin-like growth factor binding protein 1-3 (IGFBP1-3) and platelet factor 4 (PF4) are detected by protein dot assay (similar to ELISA) at nHC-HA / PTX3 (second) (FIG. 1J), Whether they are still in nHC-HA / PTX3 (4th) remains unclear.

Example 2 Preparation of immobilized HA (iHA) by covalent bond

  A series of hyaluronan (HA) amounts (0, 0.25, 0.5, 1.0, 2.5) from HMW HA (Healon, Advanced Medical Optics, Santa Ana, Calif.) Or nHC-HA / PTX3 (second). 5, 10 and 25 μg / well) of Sulfo-NHS (0.184 mg / ml) and EDAC (0.123 mg / ml) (both from Thermo Fisher Scientific, Rockford, Ill.) In addition to the containing binding solution, it was incubated for 16 hours at 4 ° C. in Covalink®-NH 96-well plates (Thermo Fisher Scientific Inc.). Wash 3 times with 8M guanidine-HCl (GnHCl) followed by PBS, and bind HA from HMW HA or nHC-HA / PTX3 to HA from Corgenix (Westminster, CO) according to manufacturer's instructions. Quantitatively measured by ELISA (FIG. 6A). HMW HA and nHC-HA / PTX3 purified from AM are dose dependent and covalently bind to the surface of Covalink-NH 96 wells. The resulting iHA or immobilized nHC-HA / PTX3 is resistant to detergents with 8M guanidine HCl. HMW HA or nHC-HA / PTX3 HA bound maximally with an HA equivalent input of 2 μg / well (FIG. 6A).

To measure binding efficiency, HA from HMW HA or nHC-HA / PTX3 was bound to Covalink®-NH per well of a 96 well plate and from HMW HA or nHC-HA / PTX3. Unbound or bound HA was measured by HA ELISA (FIG. 6B). 2 μg HA from HMW HA or nHC-HA / PTX3 was added to Sulfo-NHS (0.184 mg / ml) and EDAC (0.123 mg / ml) [1-ethyl-3- (3-dimethyl) in H ₂ O. Aminopropyl) carbodiimide] was added to Covalink®-NH 96-well plates and incubated for 16 hours at 4 ° C. (Thermo Fisher Scientific, Rockford, Ill.). Both bound and unbound HA in the wells in the wash solution (pooled) were measured by HA ELISA from Corgenix (Westminster, CO) according to the manufacturer's instructions. The total amount of HV in each well, bound or unbound, is divided by the amount of HA input (2 μg / well) to calculate the efficiency of binding or the percentage unbound. The average binding efficiency was measured to be 70.5 ± 13.4% for HMW HA and 69.0 ± 5.7% for nHC-HA / PTX3 (FIG. 6B). Thus, 2 μg / well input HA yields approximately 1.4 μg iHA.
Example 3 Activity of purified natural HC-HA / PTX3 (nHC-ha / PTX3) complex

  Binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3

RAW 264.7 cells (100 μl of 2.5 × 10 ⁵ cells / ml) [American Type Culture Collection (ATCC), Manassas, Va.) In DMEM / 10% FBS (Life Technologies, Grand Island, NY) HA (Advanced Medical Optics, Santa Ana, Calif., 2 μg / well), nHC-HA / PTX3 (2 μg / well), or 96-well plates containing PBS control and lipopolysaccharide (LPS) (1 μg / well) ml) (n = 3) [LPS-EB Ultrapure, InvivoGen, San Diego, CA]. Immobilization of HA and nHC-HA / PTX3 on the surface of Covalink-NH 96 was performed in the same manner as described above. Briefly, Covalink-NH 96-well plates were sterilized with 70% alcohol for 2 hours, washed three times with distilled water, and 96-well plates (PBS control wells were all except HA and nHC-HA / PTX3). 0.184 mg / ml Sulfo-NHS (Thermo Fisher Scientific, Rockford, Ill.) In distilled water containing 20 μg / ml HA or nHC-HA / PTX3 for every 0.13 mg / ml) and 0.123 mg / ml Added with ml EDAC (Thermo Fisher Scientific, Rockford, Ill.). Before removing the binding solution, the plates were incubated overnight at 4 ° C or 2 hours at 25 ° C, washed 3 times with PBS containing 2M NaCl and 50 mM MgSO4, and then 3 times with PBS. . After 90 minutes incubation, unbound cells were removed and bound cells were photographed and counted by CyQuant assay (FIG. 2A). More than a 3-fold increase in binding of LPS-stimulated macrophages was observed for wells containing immobilized nHC-HA / PTX3 compared to control wells. Wells containing immobilized HA inhibited binding of LPS-stimulated macrophages.

Subsequently, the cell viability of macrophages stimulated with bound LPS was examined. As described above, LPS-stimulated RAW 264.7 cells (100 μl of 2.5 × 10 ⁵ cells / ml) were immobilized on PBS control, HA, or nHC-HA / PTX3 immobilized for 24 hours. Incubated in DMEM / 10% FBS (n = 3). After incubation, the cell viability of the bound macrophages was measured by MTT assay. No significant difference (all p values> 0.05) was observed in the cell viability of cells on these immobilized substrates (FIG. 2B).

Thereafter, the ability of blocking antibodies and peptides to inhibit the binding of LPS-stimulated macrophages to immobilized nHC-HA / PTX3 was examined. RAW264.7 cells (concentration of 2.5 × 10 ⁵ cells / ml) were isolated on ice for 30 minutes on an isotype control antibody [rat IgG (10 μg / ml), mouse IgG (10 μg / ml), or Armenian hamster IgG ( 20 μg / ml)], or with RGD control peptide (1 mg / ml), CD44 (10 μg / ml), TLR2 (10 μg / ml), TLR4 (10 μg / ml), integrin αv (20 μg / ml), β1 In DMEM 10% FBS containing blocking antibodies against (20 μg / ml), β2 (20 μg / ml), or β3 (20 μg / ml), or RGD peptides (SDGRG, RGDS, GRGDS, all 1 mg / ml) Incubated (n = 3). (Antibodies against CD44 and rat IgG are obtained from BD Pharmingen (San Diego, Calif.), Antibodies against TLR2, TLR4, and mouse IgG are obtained from InvivoGen (San Diego, Calif.) And integrins αv, β1, β2, β3, and , Antibodies against Armenian hamster IgG were obtained from Biolegend (San Diego, CA), and RGD peptides were obtained from Sigma-Aldrich (St. Louis, MO)). After adding LPS (1 μg / ml), cells were seeded in plates containing immobilized HA (2 μg / well), nHC-HA / PTX3 (2 μg / well), or PBS control and incubated for 90 minutes ( n = 3). After incubation, unbound cells were removed and bound cells were photographed and counted by CyQuant assay (FIG. 2C). The results show that antibodies against CD44 and TLR4 significantly inhibited the binding of LPS-stimulated macrophages, and macrophages stimulated with LPS to nHC-HA / PTX3 to which these receptors were immobilized. It has been demonstrated to be involved in the binding.

Polarization of LPS-stimulated macrophages Polarization of LPS-stimulated macrophages to M1 or M2 phenotypes by immobilized nHC-HA / PTX3, and analysis of genes encoding M1 and M2 markers by RNA and protein analysis Examined by determining expression.

RAW 264.7 cells (100 μl of 2.5 × 10 ⁵ cells / ml) in DMEM / 10% FBS were immobilized on HA (2 μg / well), nHC-HA / PTX3 (2 μg / well) or PBS. Seeded in 96-well plates containing controls and stimulated with LPS (1 μg / ml) for 4 hours (n = 3). After incubation, non-adherent cells were removed and total RNA was extracted from adherent cells. M1 marker (tumor necrosis factor alpha (TNF-α) (Mm00443258_m1) and interleukin 12 subunit p40 (IL-12p40) (Mm00434165_m1)) and M2 marker (interleukin 10) (IL-10) (Mm00439614_m1), arginase- MRNA expression of 1 (arginine-1) (Mm00475988_m1), LIGHT / TNSF14 (Mm00444567_m1, and sphingosine kinase-1 (SPHK1) (Mm0044884_g1)) was used as an endogenous control, glyceraldehyde-3-phosphate dehydrogenase (GAPDH). ) (Mm99999915_g1) was measured by quantitative real-time PCR. Real-time PCR was performed on a 7300 Real-time PCR System (Applied Biosystems, Foster City, Calif.). The amplification program consisted of an initial activity of 10 minutes at 95 ° C., followed by 40 cycles of 15 seconds denaturation at 95 ° C., and 1 minute annealing and extension at 60 ° C. Relative gene expression data was analyzed by the relative CT method (ΔΔCT). All assays were performed in triplicate; results were normalized with GAPDH as an internal standard. All primers were from Applied Biosystems. Significant induction of expression of M2 markers IL-10, Arg-1, LIGHT, and SPHK1 compared to controls was observed in cells attached to immobilized nHC-HA / PTX3 but not HA (FIG. 3). A). Furthermore, the expression of both M1 markers, TNF-α and IL-12p40 was decreased.

  The amount of TNF-α protein secreted contained immobilized HA (2 μg / well), nHC-HA / PTX3 (2 μg / well) or PBS control as described above (n = 3). On the culture supernatant of cells treated with LPS (1 μg / ml) stimulation for 4 hours in DMEM / 10% FBS on the plate. The amount of TNF-α was measured by ELISA according to the manufacturer's protocol (R & D Systems, Minneapolis, Minn.).

  A reduced amount of TNF-α was observed in the cell culture supernatant of cells incubated on plates containing immobilized nHC-HA / PTX3 compared to PBS control (FIG. 3B). . No change in the amount of TNF-α was observed on the immobilized HA plate.

  High expression of IRF-5 is characteristic of M1 macrophages. IRF-5 directly activates transcription of genes encoding IL-12p40, IL-12p35 and IL-23p19 and represses the gene encoding IL-10. The expression of IRF-5 protein and its cytolocalization on immobilized nHC-HA / PTX3 were examined. Cells seeded on fixed control or nHC-HA / PTX3 were stimulated with LPS (1 μg / ml) for 4 or 24 hours in DMEM / 10% FBS. Expression of IRF-5 protein in cell lysates (24 hours LPS stimulation) was detected by Western blot (FIG. 3C, left) (primary antibody: abcam, Cambridge, MA; secondary antibody DAKO, Carpinteria, CA). In parallel experiments, cells (4 hours LPS stimulation) were immunostained with anti-IRF-5 antibody fixed. Intracellular localization of IRF-5 was examined by confocal immunofluorescence microscopy (LSM 700 confocal microscope, Zeiss, Oberkochen, Germany) (FIG. 3C, right). Immobilized nHC-HA / PTX3 decreased expression and prevented nuclear localization of IRF-5. These results are consistent with suppression of the M1 phenotype by immobilized nHC-HA / PTX3.

Apoptosis of activated neutrophils and phagocytosis of apoptotic neutrophils by macrophages Neutrophils are centrifuged at dextran density [Lymphocyte Poly (R), Cedarlane USA, Burlington, NC] according to the manufacturer's instructions. Used to isolate from normal human peripheral blood. Isolated neutrophils were collected on immobilized HA (2 μg / well), nHC-HA / PTX3 (2 μg / well) or PBS control on IMDM (Iscove's Modified Dulbecco's Medium, Life Technologies, Grand Island, NY) at 2 × 10 ⁶ cells / ml in 24 hours (n = 3), PBS (resting), N-formyl-methionyl-leucyl-phenylalanine (fMLP) (1 μM) (Sigma-Aldrich, St Louis) , MO) or LPS (1 μg / ml). Neutrophil apoptosis was measured in a cell lysate by Cell Death Detection ELISA (Roche Applied Science, Indianapolis, Ind.) According to the manufacturer's protocol. Immobilized nHC-HA / PTX3, not HA, promotes apoptosis of neutrophils with fMLP or LPS activity, but not resting neutrophils (D in FIG. 3).

Thereafter, phagocytosis of apoptotic neutrophils by resting or LPS-stimulated macrophages was examined. RAW264.7 cells (1 × 10 ⁵ cells / ml) were treated with immobilized HA (2 μg / well), nHC-HA / n for 6 days (n = 3) without or with LPS (1 μg / ml) stimulation. Cultured in PTX3 (2 μg / well) or DMEM / 10% FBS on PBS control. Cell culture medium was then removed and 100 μl apoptosis in IMDM (prepared by treatment of isolated resting human neutrophils with roscovitine (20 μM) (Sigma-Aldrich, St Louis, Mo.) for 8 hours). 2 × 10 ⁶ cells / ml of sex neutrophils were added to each well containing resting or LPS-stimulated macrophages. After a 30 minute incubation at 37 ° C, each well is washed three times with cold PBS and cell lysate (including macrophages and phagocytosed neutrophils) is assayed for ELISA to measure phagocytosed neutrophils by macrophages Collected to determine human myeloperoxidase (MPO) activity. Cell lysates were collected and exposed to human myeloperoxidase (MPO) ELISA assay (n = 4) (R & D Systems, Minneapolis, Minn.) According to the manufacturer's protocol. MPO was then normalized with total protein as measured by BCA protein assay (Thermo Fisher Scientific, Rockford, IL) in each cell lysate and expressed as an indicator of phagocytosis. The index of phagocytosis of resting cells without LPS (LPS) stimulation was defined as 100% in this experiment. Immobilized nHC-HA / PTX3, not HA, promoted apoptotic neutrophil phagocytosis by either resting macrophages or LPS-treated macrophages (E in FIG. 3).

These results demonstrate that immobilized nHC-HA / PTX3 (2 ^nd ) enhances activated neutrophil apoptosis and phagocytosis of apoptotic neutrophils by macrophages.

Analysis of receptors involved in the polarization of M2 macrophages by immobilized nHC-HA / PTX3 To determine the involvement of specific receptors in M2 macrophage polarization, M1 in the presence or absence of receptor blocking antibodies And quantitative mRNA expression of M2 macrophage markers. RAW264.7 cells (2.5 × 10 ⁵ cells / ml) in DMEM / 10% FBS for 30 minutes on ice (n = 3), CD44 (10 μg / ml), TLR4 (10 μg / ml), or Preincubated with PBS (control) or blocking antibody against CD44 / TLR4 (at 10 μg / ml each). Cells were then stimulated with LPS (1 μg / ml) and incubated for 4 hours at 37 ° C. on immobilized HA (2 μg / well), nHC-HA / PTX3 (2 μg / well) or PBS control. Total nucleic acid was extracted from total cells. The relative mRNA expression of the M1 marker (IL-12p40) and M2 markers (IL-10, LIGHT, and SPHK1) was measured by quantitative PCR using GAPDH as an endogenous control as described above ( FIG. 4A). IL-12p40 expression was abolished while IL-10, LIGHT and SPHK1 expression was promoted by immobilized nHC-HA / PTX3 but not HA. This expression pattern was more inhibited by the CD44 blocking antibody than the TLR4 blocking antibody. In contrast, expression of IL-12p40 and IL-10 transcripts by immobilized HA was more affected by blocking antibodies to TLR4 than to blocking anti-CD44.

  Protein expression of IL-12 and IL-10 was also measured. Cell culture supernatants were treated for 24 hours (instead of 4 hours) (n = 3), immobilized HA (2 μg / well), nHC-HA / PTX3 (2 μg / well) treated as described above. Or collected from cells cultured on PBS control. The amount of IL-12 or IL-10 protein in the cell culture supernatant was measured by ELISA (Biolegend, San Diego, Calif.) According to the manufacturer's protocol (B in FIG. 4). IL-12 protein expression is abolished, while IL-10 protein expression is significantly enhanced by immobilized nHC-HA / PTX3. This expression pattern is inhibited by blocking antibodies against CD44. In contrast, IL-12 protein expression was enhanced, while IL-10 expression was suppressed by immobilized HA, and the expression pattern was more influenced by blocking antibodies to TLR4.

Comparison of nHC-HA / PTX3 (2nd) and nHC-HA / PTX3 (4th) complexes nHC-HA / PTX3 (2nd) and nHC-HA / PTX3 (4th) induce macrophage cell aggregation (Indicating poor cell attachment) and / or by examining the ability of each complex to promote polarization of M2 macrophages. RAW264.7 cells (2.5 × 10 ⁵ cells / ml) were immobilized on immobilized HA (2, μg / well), nHC-HA / PTX3 (2, μg / well) or DMEM / 10% on PBS control. Cultured in FBS and stimulated with 200 units / ml IFN-γ / 1 μg / ml LPS (both from InvivoGen, San Diego, Calif.) For 4 or 24 hours (n = 3) . After 4 hours, cell aggregation was examined and photographed by light microscopy (FIG. 5A). Immobilized nHC-HA / PTX3 (4th), but not nHC-HA / PTX3 (2nd), promotes cell aggregation of macrophages, indicating that nHC-HA / PTX3 (4th) is attached to the plate. On the other hand, nHC-HA / PTX3 (2 ^nd ) is promoted.

After 24 hours, samples were obtained from the cell culture supernatant and the concentrations of IL-12p40 protein and IL-23 protein were measured by respective ELISA (Biolegend, San Diego, CA) according to the manufacturer's protocol (Figure 5 B and C). Both ^{nHC-HA / PTX3 (2 nd} ) and nHC-HA / PTX3 (4th) inhibits the production of a protein of IL-12p40 and IL-23 in IFN-γ / LPS stimulated macrophages.

Example 4: In vitro binding of TSG-6 and PTX3 to immobilized HA (iHA) in the absence of IαI Binding of TSG-6 to iHA Immobilized HA (2 μg / well input) Prepared as described in A series of human TSG-6 (overexpression of human TSG-6 in mouse myeloma cell line NS0 from Leu277 to Trp18 using the C terminal 10His tag, Accession # P98066; R & D Systems, Minneapolis, MN, Cat. 2104-TS) concentrations (0, 0.24, 1.2, 6, 12, and 24 μg / ml per well, in a volume of 100 μl) of reaction buffer (5 mM MgCl in PBS). ₂ , pH 7.5) and incubated with iHA at 37 ° C for 2 hours. Unbound TSG-6 was removed by washing with 8M guanidine-HCl and PBS. Bound TSG-6 was measured by a modified TSG-6 ELISA (R & D Systems, Minneapolis, Minn.). Since TSG-6 was already bound to iHA linked in the well, the step of incubating the sample with the pre-coated TSG-6 antibody was omitted. Subsequent steps followed the manufacturer's protocol (A in FIG. 7). TSG-6 binds iHA in a dose-dependent manner, when iHA is about 1.4 μg (2 μg HA per well based on binding efficiency of ˜70%), about 6 μg / ml (or 0.1 ml The maximum binding capacity was reached at 0.6 μg) in the reaction solution. The molar ratio of TSG-6 to HA was about 37: 1 based on TSG-6 being 35 kDa and HA being ˜3,000 kDa.

Thereafter, the ability of the TSG-6 / iHA complex to resist dissociation was examined. iHA (2 μg / well input) was prepared as described above.
TSG-6 (6 μg / ml in 100 μl) was incubated with iHA at 37 ° C. for 2 hours. Unbound TSG-6 was washed with PBS (as a control), or different dissociator or reducing agent: 6M guanidine HCl / PBS, 8M guanidine HCl / PBS, 2% SDS / PBS, 100 mM DTT / PBS, And was removed by washing with 25 mM NaOH / H ₂ O. Bound TSG-6 was measured by a modified TSG-6 ELISA as described above (FIG. 7B). The formed TSG-6 / iHA complex was stable and resistant to treatment with various dissociating and / or reducing agents. No statistically significant difference was noted between all groups.

Binding of PTX3 to iHA Immobilized HA (2 μg / well input) was prepared as described above. Over-expression of a series of PTX3 (Human PTX3 in mouse myeloma cell line NS0 with Glu18 to Ser277 using C-terminal 6His tag, Access # P26022; R & D Systems, Minneapolis, MN) (0 per well , 0.04, 0.2, 1, 5, and 25 μg / ml in a volume of 100 μl) in reaction buffer (5 mM MgCl _{2 in} PBS, pH 7.5) at 37 ° C. for 2 hours with iHA. Incubated. Unbound PTX3 was removed by washing with 8M GnHCl and PBS. Bound PTX3 was measured by a modified PTX3 ELISA (R & D Systems, Minneapolis, Minn.). Since PTX3 was already bound to iHA linked in the well, the step of incubating the sample with pre-coated PTX3 antibody was omitted. Subsequent steps followed the manufacturer's protocol (A in FIG. 8). PTX3 binds iHA in a dose-dependent manner and when iHA is about 1.4 μg (2 μg HA per well based on 70% binding efficiency), about 5 μg / ml (or 0.1 ml reaction solution) It reached its maximum binding capacity at 0.5 μg). The molar ratio of PTX3 to HA was approximately 24: 1 based on PTX3 being 45 kDa and HA being ˜3,000 kDa.

Subsequently, the ability of the PTX3 / iHA complex to resist dissociation was examined. iHA (2 μg / well input) was prepared as described above. PTX3 (5 μg / ml in 100 μl) was incubated with iHA at 37 ° C. for 2 hours. Unbound PTX3 washed with PBS (as a control), or different dissociator or reducing agent: 6M guanidine HCl / PBS, 8M guanidine HCl / PBS, 2% SDS / PBS, 100 mM DTT / PBS, and 25 mM Was removed by washing with NaOH / H ₂ O. Bound PTX3 was measured by a modified PTX3 ELISA as described above (FIG. 8B). The formed PTX3 / iHA complex was stable and resistant to treatment with various dissociating and / or reducing agents. No statistically significant difference was noted between all groups.

Simultaneous binding of TSG-6 and PTX3 to iHA iHA (2 μg / well input) was prepared as described above. 6 μg / ml TSG-6 and 5 μg / ml PTX3 (concentrate for maximum binding as described above), iHA alone or in reaction buffer (5 mM MgCl ₂ , pH 7.5 in PBS) Mixed and incubated. Bound TSG-6 or PTX3 was measured by the respective modified ELISA as described above. Competition or synergy for binding to iHA by TSG-6 or PTX3 when both proteins were incubated simultaneously with iHA compared to when TSG-6 or PTX3 was added alone (p> 0.05). There was no effect. These data indicated that the binding sites on iHA for TSG-6 and PTX3 are different and may not overlap (FIG. 9).

Sequential binding of TSG-6 and PTX3 to iHA Sequential addition of TSG-6 and PTX3 to iHA is examined to determine whether pre-bound TSG-6 or PTX3 inhibits binding of other proteins to iHA did. 6 μg / ml TSG-6 or 5 μg / ml PTX3 was pre-bound to iHA prepared as described above. After washing with 8M GnHCl and PBS, successive concentrates of PTX3 (0, 5 or 5 μg / ml) or TSG-6 (0, 1.2 or 6 μg / ml) were added to reaction buffer (5 mM in PBS). Of MgCl ₂ , pH 7.5), followed by subsequent incubation with pre-conjugated TSG-6 / iHA or pre-conjugated PTX3 / iHA, respectively. Subsequent bound TSG-6 and PTX3 were measured by their respective modified ELISA.

  Pre-bound TSG-6 (6 μg / ml) partially prevented subsequent PTX3 from binding to iHA (FIG. 10A) (followed by addition of PTX3 at 1 μg / ml and 5 μg / ml). P = 0.05 and 0.01, respectively (A in FIG. 5). Pre-bound PTX3 (5 μg / ml) did not prevent TSG-6 from binding to iHA (following addition of TSG-6 at 1.2 μg / ml and 6 μg / ml, respectively, p = 0.56 and 0.74) (FIG. 10B). These data indicate that iHA changes structurally after TSG-6 binding to prevent subsequent PTX3 binding.

Example 5: Adhesion of LPS-stimulated macrophages to immobilized TSG-6 / iHA and PTX3 / iHA complexes Covalent-NH 96 wells, as described above, PBS (control), HA (iHA) Or covalently linked to native HC-HA / PTX3 (nHC-HA / PTX3). TSG-6 (6 μg / ml) or PTX3 (5 μg / ml) was then added to iHA and allowed to bind. RAW264.7 macrophages (100 μl of 1 × 10 ⁵ cells / ml) in DMEM / 10% FBS were seeded into wells each connected and treated with 1 μg / ml LPS. Cell morphology was photographed after 24 hours incubation.

  Macrophages attached poorly to iHA (ie, resulting in more aggregated cells) when compared to plastic control. Such attachment is further prevented by TSG-6 / iHA, resulting in a large number and larger cell aggregation. In contrast, PTX3 / iHA promoted cell attachment and resulted in a pattern similar to that shown for immobilized nHC-HA / PTX3 (FIG. 11).

Example 6 Modulation of M1 and M2 Markers by TSG-6 / iHA and PTX3 / iHA Complex RAW264.7 cells were cultured as in Example 5, PBS (control), immobilized HA (iHA ), STG-6 / iHA, PTX3 / iHA, or nHC-HA / PTX3 for 4 hours and stimulated with 1 μg / ml LPS. Total RNA was isolated from cells and mRNA expression of M2 marker IL-10 and M1 marker IL-12p40 was measured by quantitative PCR as described above (FIGS. 12A and 12D). Alternatively, cells are stimulated with 1 μg / ml LPS (FIG. 12B and FIG. 12E) or IFN-γ / LPS (FIG. 12C) for 24 hours to induce IL-10, IL-12p70, and IL-23 protein expression. Measured in cell culture medium using each ELISA.

  Expression of IL-12p40 mRNA (one of the two subunits of IL-12p70) is markedly higher on iHA (none) compared to control (Ctrl) (p> 0.05) expression. There was no change (FIG. 12A). In contrast, IL-12p40 mRNA was significantly upregulated on TSG-6 / iHA (p <0.01), but PTX3 / iHA and nHC-HA / PTX3 (p <0.05). It was significantly down-regulated above (Figure 12A). However, expression of IL-12p70 protein was only detectable without significant difference (p> 0.05) on control or iHA alone, but TSG-6 / iHA, PTX3 / iHA, and nHC-HA It cannot be detected on / PTX3 (FIG. 12B). IL-12p40 also functions as a subunit of IL-23. IL-23 protein expression was significantly upregulated on TSG-6 / iHA and PTX3 / iHA (p <0.01) but not detectable on nHC-HA / PTX3 (p <0.05) Was observed (FIG. 12C). These data indicate that both TSG-6 / iHA and PTX3 / iHA are effective in suppressing IL-12 but not IL-23.

  IL-10 mRNA expression by RAW264.7 cells did not change significantly on iHA alone compared to control (p> 0.05), but TSG-6 / iHA, PTX3 / iHA, and nHC -Remarkably upregulated on HA / PTX3 (p <0.05) (Figure 12D). However, IL-10 protein expression is only significantly upregulated on PTX3 / iHA, similar to the positive control of immobilized nHC-HA / PTX3 (p <0.05) (FIG. 12E). These data show that after different patterns of cell attachment (Example 5), the resulting cells show different functions, with PTX3 / iHA up-regulating IL-10 over TSG-6 / iHA. It shows that it is effective.

Example 7: In vitro transfer of HC1 and HC2 from IαI to immobilized HA Covalent-NH 96 wells were washed with PBS (control), HA (iHA), or native HC, as described above. -Covalently bound to HA / PTX3 (nHC-HA / PTX3). Successive TSG-6 concentrates (0, 0.24, 1.2, 6, 12 μg / ml in 100 μl) were individually treated with iHA in reaction buffer (5 mM MgCl ₂ , pH 7.5 in PBS). Incubated in Human IαI (prepared from human plasma according to Blom et al. (1999) J. Biol. Chem. 274, 298-304) was added simultaneously or sequentially (after 2 hours) with TSG-6. It was. Bound HC1, HC2 (antibodies to HC1 and HC2 were from Abcam, Cambridge, MA), or IαI (DAKO, Carpinteria, Calif.), Similar to the TSG-6 and PTX3 ELISA described above Measured by each modified ELISA.

  The data show that HC1 bound to iHA (FIG. 13A) or IαI (when TSG-6 was pre-bound to iHA with subsequent addition of IαI, rather than when TSG-6 and IαI were added simultaneously, FIG. 13B) shows that the amount is lower at higher TSG-6 concentrations (6 and 12 μg / ml). HC2 was not detected in the sample (data not shown). To digest the bound HA and release the bound protein from the HA, the wells were incubated with hyaluronidase and these samples were analyzed by Western blot using anti-TSG-6 antibody (R & D Systems, Minneapolis, MN). The amount of TSG-6 bound to iHA was added at the same time as TSG-6 than when IαI was subsequently added (ie, after TSG-6 was bound to iHA (FIG. 13C)). Sometimes less. When 5 μg / ml PTX3 and 5 μg / ml IαI were co-incubated with iHA, PTX3 but not IαI was bound to iHA (FIG. 13D).

These data indicate that free TSG-6 in solution is more effective in transferring HC1 from IαI onto iHA than TSG-6 bound to iHA ( 13A and 13B). More TSG-6 is bound to iHA when TSG-6 is pre-bound to iHA alone than when TSG-6 and IαI are co-incubated with iHA (FIG. 13C). IαI prevents TSG-6 from binding to iHA when -6 is added simultaneously, indicating that TSG-6 may have a higher affinity when binding to IαI than iHA .
Furthermore, TSG-6 released in solution or bound to iHA does not transfer HC from IαI to iHA (FIG. 13D).

Example 8: Effect of PTX3 on the formation of HC1 • TSG-6 and HC2 • TSG-6 complexes IαI (40 μg / ml) and TSG-6 (6 μg / ml) were treated with PTX3 (20 μg / ml or 120 μg / ml). ) With or without) at 37 ° C. for 2 hours in reaction buffer (5 mM MgCl _{2 in} PBS, pH 7.5). Reaction samples were prepared using antibodies against HC1 (FIG. 14A), HC2 (FIG. 14B), TSG-6 (FIG. 14C), bikunin (Abcam, Cambridge, MA) (FIG. 14D), and PTX3 (data not shown). Analyzed by Western blot. In a solution without HMW HA, TSG-6 forms a complex of HC1 • TSG-6 and HC2 • TSG-6, producing HMW IαI (FIGS. 14A and 14B). The formation of HMW IαI is illustrated in FIG. 14E. This data shows that both HC1 and HC2 are transported to HMW HA by TSG-6 in solution.

  Simultaneous addition of PTX3 inhibits the formation of HC2 • TSG-6 but not HC1 • TSG-6 in a dose-dependent manner (FIGS. 14A and 14B). In contrast, HMW IαI containing HC2 is increased, but HMW IαI containing HC1 is decreased (FIGS. 14A and 14B). TSG-6 forms a dimer when added in a solution without HMW HA with or without PTX3 (FIG. 14C). These results show that 1) both HC1 and HC2 in IαI form a complex with either TSG-6 or HMW IαI through the action of TSG-6; 2) PTX3 is TSG-6 It shows that the above process is disturbed separately with respect to the transport of HC1 and HC2. There is no truncated form of HC1 or HC2. Inhibition of HC2 • TSG-6 by PTX3 is illustrated in FIG. 14F.

  The glyconated and glycosylated and chondroitin sulfate bound forms of bikunin, respectively, of about 40 kDa and 45 kDa were released by TSG-6 and PTX3, respectively (FIG. 14D). This data is consistent with published data showing that both TSG-6 and PTX3 interact with IαI, and TSG-6 and PTX3 interact with IαI separately, resulting in Suggesting that bikunin may produce different results.

In separate experiments, HMW HA (250 μg / ml), IαI (40 μg / ml), and TSG-6 (6 μg / ml) were mixed with PTX3 in reaction buffer (5 mM MgCl ₂ , pH 7.5 in PBS). Incubated in solution for 24 hours at 37 ° C. with or without (1, 2.5 and 5 μg / ml). The reaction samples were analyzed by Western blot using an antibody against IαI (FIG. 14G). In the solution with HMW HA but without PTX3, HC from IαI was completely transferred to HMW HA by TSG-6. In the presence of PTX3, TSG-6 mediated HC transport is inhibited in a dose-dependent manner, resulting in LMW intermediate (consisting of ~ 130 kDa and possibly HC1-TSG-6) or untreated pre This results in the accumulation of IαI (˜130 kDa, untreated IαI) (220 kDa), and HMW IαI (retained in loading wells) (FIG. 14G). These data are consistent with the results that PTX3 specifically prevents the formation of HC2-TSG-6, resulting in inhibition of HC2 transport and possible HC1 transport.

Example 9: Formation of reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex in vitro from immobilized HA by simultaneous addition of TSG-6, PTX3 and IαI immobilized HA (each ˜14 μg / ml or 1.4 μg in 100 μl in wells was prepared as described in Example 3. IαI (5 μg / ml) and TSG-6 (12 μg / ml) were added to PTX3 (1, 5 or 20 μg / ml) in reaction buffer (5 mM MgCl _{2 in} PBS, pH 7.5) for 2 hours at 37 ° C. ) With or without) and simultaneously incubated on iHA. After washing with 8M GnHCl and PBS, bound HC1, TSG-6, and PTX3 were measured by respective modified ELISAs (A, D, and F, respectively, in FIG. 15). The wells were washed again with 8M GnHCl and PBS and iHA with binding components was washed with 1 unit / ml hyaluronidase for 2 hours at 60 ° C. in 10 mM buffered acetic acid solution using 75 mM NaCl, pH 6.0. Digested. Samples were analyzed by Western blot using antibodies against HC1 (FIG. 15B), HC2 (FIG. 15C), TSG-6 (FIG. 15E), and PTX3 (FIG. 15G).

  Co-addition of TSG-6, PTX3 and IαI to iHA resulted in the rcHC-HA / PTX3 complex containing HMW HC1, but not HC2, and cleaved HC1 and HC2 (FIG. 15 AC). PTX3 dose-dependently reduced the amount of HMW HC1 in the complex. Data show that PTX3 interfered with the transport of HC1 and HC2 to HC2 by TSG-6 in a dose-dependent manner (FIG. 15 AC), resulting in less HC1 / cleaved HC1 and cleaved It shows that it resulted in HC2 (B and C in FIG. 15). While TSG-6 monomer was reduced, HMW TSG-6 (either multimeric or complexed by PTX3 and / or HC) did not change (D and E in FIG. 15).

  The data also shows that PTX3 does not interfere with iHA-bound TSG-6 in the presence or absence of IαI. Published data suggests that TSG-6 forms a dimer with iHA when smaller MW HA is tested (Baranova et al. (2011) J Biol Chem. 286 ( 29): 25675-86). The data presented herein indicates that TSG-6 is complexed in the HMW HC-HA / PTX3 complex in the presence of IαI. It is further shown that PTX3 promotes binding of TSG-6 to the HC-HA / PTX3 complex in the presence of IαI because free TSG-6 is reduced by PTX3 in a dose-dependent manner. Under this circumstance, the majority of PTX3 exists as a multimer in the HC-HA / PTX3 complex, similar to that observed in nHC-HA / PTX3, monomer, dimer or ternary. The amount of the mer is decreasing (F and G in FIG. 15).

Example 10: Effect of sequential addition of PTX3 to reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex generated in vitro with TSG-6 and IαI on immobilized HA HA (˜14 μg / ml) was prepared as described in Example 3. IαI (5 μg / ml) and TSG-6 (12 μg / ml) were incubated on iHA in reaction buffer (5 mM MgCl ₂ , pH 7.5 in PBS) at 37 ° C. for 2 hours. After removing unbound IαI and TSG-6, the reaction buffer with or without PTX3 (1, 5 or 20 μg / ml) was washed with pre-bound HC and TSG-6 at 37 ° C. for 2 hours. Incubated. After washing with 8M GnHCl and PBS, bound HC1, TSG-6, and PTX3 were measured by respective ELISAs (A, D, and F, respectively, in FIG. 16). The wells were then washed again with 8M GnHCl. The PBS control with binding component and iHA were then digested with 1 unit / ml hyaluronidase for 2 hours at 60 ° C. Samples were analyzed by Western blot using antibodies against HC1 (FIG. 16B), HC2 (FIG. 16C), TSG-6 (FIG. 16E), PTX3 (FIG. 16G).

  When TTX-6 and HC are pre-coupled to iHA followed by PTX3, PTX3 reduces HC1 transport to the HMW complex in a dose-dependent manner (intact HC1 and cleaved Both HC1 are reduced) but increases the amount of cleaved HC2 in the complex. Consistent with the data shown in Example 7, bound TSG-6 is not as effective at transporting HC to iHA as TSG-6.

Similar to the data shown in Example 8, PTX3 also dose-dependently reduced HMW TSG-6 and monomeric TSG-6 (FIGS. 16D and E), which is followed by PTX3 The addition indicates that the pre-bound TSG-6 is continuously consumed.
However, PTX3 cannot be further incorporated into the TSG-6 / HC-HA complex (F and G in FIG. 16). Since prebound TSG-6 in iHA also partially prevents PTX3 from binding to iHA (see Example 4), this result indicates that the rcHC-HA / PTX3 complex by TSG-6 and IαI The formation of the body shows that it is structurally different from TSG-6 / iHA to the extent that PTX3 binding to iHA is completely excluded.

Example 11: Formation of reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex and sequential addition of TSG-6 and IαI in vitro with pre-bound PTX3 on immobilized HA Immobilization HA (˜14 μg / ml) was prepared as described in Example 3. PTX3 (5 μg / ml) and iHA were incubated in reaction buffer for 2 hours at 37 ° C. in reaction buffer (5 mM MgCl ₂ , pH 7.5 in PBS). After removing unbound PTX3, reaction buffer containing TSG-6 (6 μg / ml) and IαI (5, 25 and 125 μg / ml) was incubated at 37 ° C. for 2 hours. After washing with 8M GnHCl and PBS, bound HC1, TSG-6, and PTX3 were measured by the respective ELISA (A, C, and E, respectively, in FIG. 17). The wells were then washed again with 8M GnHCl. PBS or iHA with binding components were digested with 1 unit / ml hyaluronidase in 10 mM buffered acetic acid solution using 75 mM NaCl, pH 6.0 for 2 hours at 60 ° C. Samples were analyzed by Western blot using antibodies against PTX3 (FIG. 17B), TSG-6 (FIG. 17D), HC1 (FIG. 17F) and HC2 (FIG. 17G).

  In the presence of IαI and TSG-6, pre-bound PTX3 increased the immunoreactivity of ELISA against PTX3 and the amount of multimeric PTX3 in a dose-dependent manner, but in the HC-HA / PTX3 complex. The amount of monomeric PTX3 was reduced (FIGS. 17A and B). This data indicates that multimeric PTX3 promotes immunoreactivity with this antibody.

  Pre-bound PTX3 excluded monomeric TSG-6 in a dose-dependent manner while reducing TSG-6 in the rcHC-HA / PTX3 complex (FIGS. 17C and D). . When the molar ratio of IαI to TSG-6 is 3: 1, a significant decrease in bound TSG-6 (both monomeric and HMW forms) is detected and bound multimeric PTX3 is similarly maximally To be.

  There was no significant change in bound HC1 based on HC1 ELISA data (FIG. 17E). HC2 transport was increased in a dose-dependent manner by increasing IαI concentration.

Example 12: Between reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex formed in vitro by pre-bound TSG-6 against pre-bound PTX3 on immobilized HA Comparison of Macrophage Cell Adhesion Activity Covalink-NH 96 wells were covalently bound with PBS (control), HA (iHA), or nHC-HA / PTX3 as described in Example 3. IαI (5 μg / ml), TSG-6 (6 μg / ml) or PTX3 (5 μg / ml) were bound to iHA simultaneously or sequentially as follows: (1) (IαI / TSG-6 / PTX3 ) / IHA: IαI, TSG-6, and PTX3 were co-incubated with iHA for 2 hours at 37 ° C. in reaction buffer; (2) (IαI / TSG-6) / PTX3 / iHA: IαI and TSG- 6 was first incubated with iHA for 2 hours at 37 ° C. in reaction buffer. After removal of unbound IαI / TSG-6, it was washed with 8M GnHCl and PBS, PTX3 was added and incubated in reaction buffer at 37 ° C. for 2 hours; (3) (PTX3) / IαI / TSG- 6 / iHA: PTX3 was first incubated with iHA for 2 hours at 37 ° C. in reaction buffer. After removing unbound PTX3, it was washed with 8M GnHCl and PBS, IαI / TSG-6 was added, and incubated in reaction buffer at 37 ° C. for 2 hours. After complex formation, 100 μl of RAW264.7 cells (1 × 10 ⁵ cells / ml) were seeded into wells to which they were linked and treated with 1 μg / ml LPS. Cell morphology was photographed after 24 hours incubation.

Macrophages attached poorly to iHA as a control.
In the presence of IαI, TSG-6 simultaneously or pre-bound to iHA ((IαI / TSG-6 / PTX3) / iHA or (IαI / TSG-6) / PTX3 / iHA) inhibits cell attachment, Promotes cell aggregation (FIG. 18) similar to the state without IαI (see Example 5). In contrast, pre-bound PTX3 to iHA [(PTX3) / IαI / TSG-6 / iHA] promotes cell attachment similar to pre-bound PTX3 without IαI as shown in Example 5. . The latter is similar to the nHC-HA / PTX3 positive control (FIG. 18).

Example 13: Between reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex formed in vitro by pre-bound TSG-6 against pre-bound PTX3 on immobilized HA Comparison of modulation of M1 and M2 marker expression IL-10 and IL-12p40 expression in macrophages cultured on rcHC-HA / PTX3 complexes RAW 264.7 cells were fixed as described in Example 12. Incubated in DMEM / 10% FBS on activated substrate and stimulated with 1 μg / ml LPS for 4 hours. Total RNA was isolated, and expression of IL-10 and IL-12p40 mRNA was measured by quantitative PCR as described above (FIGS. 19A and 19C). Alternatively, cells were stimulated with 1 μg / ml LPS for 24 hours and IL-10 and IL-12p70 proteins in cell culture supernatants were measured by respective ELISA (FIGS. 19B and 19D).

  Compared to the PBS control, IL-10 mRNA expression was not significantly altered by iHA (p = 0.56), but TSG-6, IαI, and PTX3 on iHA (IαI / TSG in FIG. 19). -6 / PTX3 (a)) (p = 0.0008) was significantly upregulated on the complex formed. Similarly, the expression of IL-10 mRNA was determined by adding IαI and PTX3 (IαI / TSG-6 / PTX3 (b) in FIG. 19) (p = 0.04) followed by the positive control nHC-HA / PTX3 (p = 0.008) was significantly upregulated on the complex formed by pre-bound TSG-6 against iHA. The expression of IL-10 mRNA was significantly higher on nHC-HA / PTX3 than IαI / TSG-6 / PTX3 (a) (p = 0.04), but IαI / TSG-6 / PTX3 (b) ( p = 0.55) not as high as above. In contrast, IL-10 mRNA expression is marked on the complex formed by pre-bound PTX3 to IHA (IαI / TSG-6 / PTX3 (c) in FIG. 19) (p = 0.74). Not up-regulated (Figure 19A). IL-10 protein expression was only significantly upregulated by nHC-HA / PTX3 (p = 0.03) as measured by ELISA (FIG. 19B).

  Compared to the control, IL-12p40 (IL-12p40 is one of the two subunits of IL-12p70 and the other subunit is IL-12p35) mRNA expression is significantly increased by iHA. There was no change (p = 0.1). In contrast, IL-12p40 mRNA expression is formed by co-addition of TSG-6, IαI, and PTX3 (IαI / TSG-6 / PTX3 (a) in FIG. 19) (p = 0.05) on iHA. Markedly up and on the complex formed by pre-bound TSG-6 to IHA (IαI / TSG-6 / PTX3 (b) in FIG. 19) (p = 0.04) Regulated. In contrast, IL-12p40 mRNA expression was completely abolished on the complex formed by pre-bound PTX3 (IαI / TSG-6 / PTX3 (c) in FIG. 19), and nHC-HA / Remarkably down-regulated by PTX3 (p = 0.01). There was a statistically significant difference between the latter two states (p = 0.04) (FIG. 19C). Compared to the control, the expression of IL-12p70 protein was not significantly altered by iHA (p = 0.32), but pre-bound PTX3 (IαI / TSG-6 / PTX3 (c)) (p = 0.03) was significantly down-regulated on the complex formed (Fig. 19D). In contrast, the expression of IL-12p70 protein is a complex formed by co-addition of TSG-6, IαI and PTX3 (IαI / TSG-6 / PTX3 (a)) on iHA, pre-bound PTX3. The complex formed by (IαI / TSG-6 / PTX3 (c)) and disabled on nHC-HA / PTX3 (p = 0.05, 0.02, and 0.01, respectively).

Expression of IL-23 in macrophages cultured in the presence of various stimuli In separate experiments, IFN in resting RAW264.7 cell (no) cell culture supernatant, or 24 hours of DMEM / 10% FBS -Γ (200 units / ml), LPS (1 μg / ml), IFN-γ / LPS, immune complex or IC (LPS / IC) [IC is 150 μg / ml IgG opsonized OVA (IgG-OVA) And made a 10-fold molar excess of rabbit anti-OVA IgG (Cappel, Durham, NC) against OVA (Worthington Biochemical Corp., Lakewood, NJ) for 30 minutes at 25 ° C. LPS having (1 μg / ml), or IL-4 (10 ng / ml) R & D Systems, Minneapolis, the IL-23 protein in the cell culture supernatants by stimulation of MN) were measured. IL-23 protein in the cell culture supernatant was measured by IL-23 ELISA (Biolegend, San Diego, Calif.) According to the manufacturer's protocol (FIG. 19E). IL-23 protein is under resting RAW264.7 cells and LPS (1 μg / ml), LPS with immune complex (LPS / IC), or 4 hours under stimulation with IL-4 (10 ng / ml) Although not detectable in the cell culture supernatant of the cells, it became detectable under stimulation for 24 hours with IFN-γ (200 units / ml) and IFN-γ / LPS (FIG. 19E).

Expression of IL-23 in macrophages cultured on rcHC-HA / PTX3 complex In a separate experiment, RAW264.7 cells were cultured on immobilized substrate as described above and 24 hours IFN- Stimulated with γ / LPS. IL-23 in the cell culture supernatant was measured by IL-23 ELISA as described above (FIG. 19F).

  Compared to the control, IL-23 protein in the cell culture supernatant of RAW264.7 cells stimulated with 200 units / ml IFN-γ / 1 μg / ml LPS for 24 hours was iHA (p = 0.02). A complex formed by the simultaneous addition of TSG-6, IαI, and PTX3 (IαI / TSG-6 / PTX3 (a)) (p = 0.002) on iHA, and It was significantly upregulated on the complex formed by pre-bound TSG-6 to IHA (IαI / TSG-6 / PTX3 (b)) (p = 0.0005). In contrast, IL-23 protein is expressed by pre-bound PTX3 (IαI / TSG-6 / PTX3 (c)) (p = 0.05) similar to nHC-HA / PTX3 (p = 0.05). Completely invalidated on the formed complex (FIG. 19F).

Example 14: Use of HC-HA / PTX3 for the Treatment of Chronic Graft Versus Host Disease Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for hematological malignancies. However, chronic graft versus host disease (cGVHD) remains a major complication. GVHD causes some onset of ocular symptoms in 45-60%, among which dry eye is the most frequent complication that occurs in nearly 50% of allogeneic HSCT recipients. Indeed, dry eyes is a unique sign and symptom for the diagnosis of cGVHD. Patients with cGVHD show either early mild dry eye disease associated with cGVHD or so-called “differential characteristics of cGVHD” depending on the classification of the NIH consensus conference.
Two types of dry eye following HSCT are mentioned; one has severe ocular surface and tear function damage, with reduced reflex tearing that occurs shortly after the onset of dry eye, The other is mild with normal reflex tears. Ocular dryness typically occurs 6 months after transplantation, and severity has been reported to be associated with the presence of cGVHD and meibomian gland disease. The onset of cGVHD-related severe eye dryness is earlier than the onset of mild eye dryness. For example, severe eye dryness occurs 6.8 ± 2.5 months after HSCT, while mild eye dryness occurs 13.2 ± 9.1 months after HSCT. A comparative study of 50 eyes of 25 post-HSCT patients and 28 eyes of 14 age-matched healthy controls showed MG occlusion, reduced corneal sensitivity, corneal sensitivity, enhanced tear evaporation Shows that rate, decreased conjunctival GCD, increased conjunctival squamous metaplasia and inflammatory cells were more prominent in cGVHD-related ocular dryness than after normal controls without HSD and HSCT It was. Furthermore, conjunctival inflammatory cells were significantly more in severe eye dryness compared to mild eye dryness (P <0.03). In addition, the most severe dry eye patients had systemic cGVHD, but in the mild dry eye group, only a few patients had systemic cGVHD. These results suggested different pathological processes in cGVHD-related severe and mild dry eye disease. Because global ocular surface changes were significant in patients after HSCT, regardless of whether the patient had cGVHD-related eye dryness, their results indicate that the extent of the inflammatory process is cGVHD It suggests that it seems to have a central role in the associated dry eye results. Conjunctival brush cytology specimens showed a significant increase in inflammatory cells in patients with both cGVHD-related severe and mild ocular dryness compared to normal controls without dry eye subjects and after HSCT. Indicated. Moreover, the number of inflammatory cells in severe dry eye specimens was significantly higher than in mild dry eye specimens. In addition, many inflammatory markers appeared from cGVHD-related dry eye patients in conjunctival and lacrimal gland biopsy samples, confirming that inflammation is related to the pathogenesis of cGVHD-related dry eye.

  One possible cause of many scarring complications in cGVHD is due to EMT of the conjunctival basal and lacrimal myoepithelium as a result of cytokines released by chronic inflammation by infiltrating donor lymphocytes is there. Previously, it was recognized that inflammation and excessive fibrosis were prominent histological features of chronic graft-versus-host disease (cGVHD), but the mechanisms underlying these changes remain unknown . cGVHD exhibits characteristics similar to scleroderma, indicating marked fibrosis, pulmonary fibrosis, and chronic immunodeficiency in skin lesions. The clinical picture of ocular cGVHD is characteristic of dry, gritted or painful eyes, scarring conjunctivitis, including the formation of subconjunctival fibrotic vascular tissue, and strong conjunctival fibrosis Includes the onset of membrane shortening. In addition to the characteristics of sclerosis in skin lesions, together with mucosal atrophy in the oral cavity, stenosis or stenosis in the upper to middle third of the esophagus, joint stiffness or contracture due to sclerosis, and obstructive bronchitis in the lung Show the characteristics of systemic GVHD-mediated fibrosis. The main histological result in the affected exocrine glands and mucosa is a marked increase in the number of fibroblasts and fibroblasts associated with mild lymphocyte infiltration. Clinically, the severity of dry eyes is related to the degree of fibrotic change, rather than the amount of lymphocyte infiltration, which is due to excessive extracellular matrix accumulation, mainly dysfunction of the exocrine glands It is suggested that it contributes to. Fibroblasts in the stroma also play a role in inflammation by attaching to lymphocytes and by expressing human leukocyte antigen class II and costimulatory molecules. Together, these results suggest that fibroblasts play an important role in the pathogenesis of cGVHD. Furthermore, it has been discovered that fibroblasts accumulated in the lacrimal glands of cGVHD patients are in a chimeric state. Thus, fibroblasts arising from circulating donor-derived precursors and recipient-derived fibroblasts can be associated with excessive fibrosis in patients with cGVHD due to interacting T cells. It remains unknown whether control of inflammation through suppression of T cell infiltration leads to less scarring complications in cGVHD.

  Previously, donor-derived fibroblasts were detected in human cGVHD tissue samples by combining immunohistochemical examination and Y-chromosome fluorescence in situ hybridization (FISH) methods. Zhang et al. Using the murine model of cGVHD established by ((2002) J Immunol. 168: 3088-3098), the above results can be reproduced. In this model, tear volume begins to decrease 3 weeks after transplantation. Early fibrosis around the lacrimal duct and progressive fibrosis are detected as early as 3 weeks after implantation and gradually progress up to 8 weeks in a manner similar to human samples. This experiment was performed more than 20 times to be successful in both the GVHD and control groups, resulting in an overall reproduction of 70-80% based on analysis of lacrimal gland tissue samples and tear volume.

In a typical transplantation study, 7-8 week old male and female B10. D2 (H-2d) and BALB / c (H-2d, Sankyo Laboratory, Ltd.) mice were used as donors and recipients, respectively, using spleen cells added as a source of mature T cells. The Briefly, female recipient mice are lethally irradiated with 700 cGy from a source of Gammacel 137Cs (J. L. Shepherd & Associates, San Fernando, Calif.). Approximately 6 hours later, they were in the bone marrow (1 × 10 ⁶ / mouse) and spleen (2 × 10 ⁶ / mouse) of male donors suspended in RPMI 1640 (BioWhittaker, Walkersville, MD) by the tail vein. Cells are injected. The control group (syngeneic BMT) consists of female BALB / c recipient mice that receive the same number of male BALB / c spleen and bone marrow cells. (Zhang et al. (2002) J Immunol. 168: 3088-3098). For HC-HA / PTX3 treatment, the HC-HA / PTX3 complex is administered by subconjunctival injection at a predetermined time after bone marrow transplant, such as 7, 14, 21, and 28 days after bone marrow transplant.

  The effects of treatment include, but are not limited to, measurement of lacrimal fibrosis using Mallory staining, collagen-specific molecular chaperone, HSP47, as a marker of activated fibroblasts, per field Measurement of the number of activated fibroblasts, measurement of the production of lacrimal tear under pilocarpine stimulation using the cotton yarn test, and HSP47, IL-4 using RT-PCR Assessed using assays, including determination of levels of fibrogenic cytokines such as IL-6, and TGFbeta.

  Treatment with the HC-HA / PTX3 complex is expected to result in a reduction of lacrimal fibrosis in a mouse model. The HC-HA / PTX3 complex is then administered in a clinical setting by subconjunctival injection into a human subject for the treatment of dry eyes caused by cGVHD.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). . In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 15: Use of HC-HA / PTX3 for the treatment of inflammation in a mouse model In this example, anti-inflammatory efficacy is tested in a murine model of HSV-1 necrotizing keratogenic keratitis. A total of 240 female BALB / c mice (6-8 weeks old) obtained from Charles River Wiga (Sulzfeld, Germany) are anesthetized by intraperitoneal injection of 2 mg ketamine HCl and 400 ng mepivacaine HCl. For each mouse, the cornea in the middle of one eye is scratched under a surgical microscope with a cross pattern with 8 horizontal scratches and 8 vertical scratches using a 27 gauge needle. . To each damaged cornea, 5 μl of a suspension containing 1 × 10 ⁵ plaque-forming units of HSV-1 virus (KOS strain) was applied and they were routinely propagated on Vero cells. Stored at −80 ° C., and quantified by standard plaque assay. On day 14 after HSV-1 infusion, the corneas of mice that developed severe ulcerated parenchymal keratitis were included for study (approximately 50% yield) and subdivided into three groups. Each of 40 corneas (n = 6 for clinical examination, n = 5 for histological examination, n = 5 for immunostaining, n = 6 for cytokine ELISA, for TUNEL N = 5, and n = 10 for flow cytometry, and n = 3 for wear / backup). An uninfected bureaucratic eye is used as a negative control group. The positive control group undergoes a turret suture using 2 10-0 nylon suture to close the eyelid. The experimental HC-HA / PTX3 group undergoes the same pelvic suture as the positive control and receives topical application of the composition containing purified HC-HA / PTX3 complex four times a day. The experimental HA group will receive the same pelvic suture, but will receive topical application of the composition of HA alone 4 times a day. Two days later, the pelvic suture is removed in all three groups. Using a surgical microscope (Zeiss, Germany), the severity of each corneal stromal inflammation is assessed by a score of 0 to 4+, 1+ is less than 25%, 2+ is less than 50%, 3+ is less than 75% , And 4+ have corneal opacity with corneal neovascularization, corneal edema, and corneal thinning between 75% and 100%. After cervical dislocation following euthanasia by a CO ₂ chamber, the five corneas from each group were CD11b (neutrophils and macrophages), F4 / 80 (macrophages), Gr-1 (PMN), and CD3 (T Primary antibody to cells) (see Methods) and another five corneas from each group undergo hematoxylin-engine staining and TUNEL staining. In addition, corneal homogenates prepared from six corneas from each group are subjected to ELISA measurements of IL-1α, IL-2, IL-6, IFN-γ and TNFα levels. Cells released from 10 corneas of each group by collagenase were used for flow cytometry to quantify live cells by MTT assay and apoptotic cells by Annexin V-PE Apoptosis Detection Kit (BD-Pharmingen, Heidelberg, Germany). To be prepared.

  It is expected that 50% of mouse HSV-1 infected corneas will develop severe keratotic keratitis (inflammation), corneal edema, and corneal ulcers two weeks after inoculation included for the study. After 2 days, the uninfected cornea remains normal, while the infected cornea in the control group maintains similar severe inflammation when the pelvic suture is removed. Similar to the control group, the cornea in the experimental HA group shows similar severe inflammation. In contrast, the corneas of the experimental HC-HA / PTX3 group showed a decrease in inflammation, which is based on histology and immunostaining for CD11b, F4 / 80, Gr-1, and CD3 ( PMN / macrophages) and greatly reduced immune (T cell) infiltration, inflammatory and immune cytokines such as ELISA-based IL-1α, IL-2, IL-6, IFN-γ, and TNF-α Significantly reduced, and TUNEL positive cells in corneal tissue and released from the cornea by collagenase when compared to positive control and experimental HA groups (flow cytometry using Annexin-V / 7-AAD) Associated with and embodied by a significant increase in dead (MTT) and apoptotic cells. Taken together, these data support the notion that the HC-HA / PTX3 complex exerts clinical anti-inflammatory efficacy in this murine HSV-1 model.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 16: Use of HC-HA / PTX3 to inhibit scarring in a rabbit model In this example, the efficacy of anti-scarring is demonstrated in a rabbit model of excimer laser assisted laser refractive keratotomy (PRK). Tested. A total of 30 New Zealand white rabbits of any gender and weighing 2.5-3.0 kg (BW) are used and subdivided into the following three groups (n = 10 each): PRK control group, PRK HA group, and PRK HC-HA / PTX3 group. Prior to PRK and during all CMTF studies, rabbits were injected intramuscularly with 5 mg / kg BW xylazine and 30 mg / kg BW ketamine and topically with 0.5% tetracaine HCl eye drops (Ortopics Laboratories Corp, Fairton, NJ). For the two PRK groups, the corneal epithelium of one animal in each animal was manually removed by lightly scraping with a dull spatula in an area slightly larger than the excised area, and the peeled stroma was usually irrigated with saline. , And excess fluid is lightly removed with a cellulose sponge. A standard 6 mm diameter, 9.0 D PRK myopic correction PRK is used to achieve a predicted theoretical interstitial ablation depth of 118 μm, LadderVision Excimer Laser (Alcon, Ft. Worth, TX). Is done using. Immediately after and after PRK, the PRK HC-HA / PTX3 group is applied with a composition containing the HC-HA / PTX3 complex, while the PRK HA group contains a composition containing HA alone. The thing is applied both 4 times a day and then for a total of 3 weeks. In addition, all PRK treated eyes are injected with topical 0.1% sodium diclofenac (one drop after PRK) and 0.3% gentamicin sulfate (3 times daily for 3 days).

In vivo CMTF was used prior to PRK and its 1, 2, 3, and 4 weeks using a modified Tandem Scanning Conferencing Microscope with a 24X surface contact objective lens (Tandem Scanning Corporation, Reston, Va.) Later, 2 months and 4 months later, it is performed on all operated eyes (n = 6 from each group). After standard confocal examination of the corneal morphology, the video camera settings (gain, kilovolt, and black level) can be switched to manual and kept constant during the study, allowing direct comparison of all scans To. The CMTF is performed as a continuous Z-axis scan across the entire cornea. The thickness of the cornea, epithelium, and stroma is mapped into the central 3 mm area by performing 10 consecutive CMTF scans in the area covering all areas. Only the data obtained from the thinnest interstitial region corresponding to the center of the light release characteristic is used for subsequent calculations. A CMTF characteristic based on the depth of the image intensity results from the CMTF recording. The light reflectance of the cornea is measured by the CMTF characteristics and is expressed in arbitrary units (U) defined as μm ^* pixel intensity as an evaluation of corneal opacity.

  To identify and measure the presence of interstitial fibrous tissue, 3 PRK treated animals from each group (control group and treatment group) were treated with 0.2 M sodium bicarbonate as previously reported. Stained with 0.5% 5- (4,6-dichlorotriazinyl) aminofluorescein (DTAF) dissolved in. After 2 minutes of staining, the eye is thoroughly washed to remove excess dye prior to topical antibiotic administration. Four months after PRK, the animals are euthanized by intravenous injection of sodium pentobarbital (120 mg / kg BW). After euthanasia, all corneas were fixed in situ by anterior chamber perfusion of 2% paraformaldehyde in PBS pH 7.2 for 3 minutes, excised, placed in fresh fixative, and 4 ° C. Saved with. The tissue was then embedded in OCT, snap frozen in liquid nitrogen, and cut using a freezing microtome. Tissues were continuously stepped to identify the center and deepest part of photoexfoliation, keratocan, CD3434, FITC-conjugated phalloidin, ED-A fibronectin, S-100A4 and α-smooth Exposure to immunostaining using antibodies against muscle actin (α-SMA) can cause changes in corneal opacity (due to CMTF light reflectance) from corneal parenchymal cells to fibroblasts or myofibroblasts. Correlate with phenotypic changes. Furthermore, in these eyes stained with DTAF, the thickness of the fibrous tissue deposited is between the basal epithelial cells and the DTAF-stained corneal tissue representing the original, intact corneal matrix. Measured by determining distance.

  In vivo confocal microscopy is expected to reveal characteristic epithelial, basement membrane, stroma and endothelium features, which show that CMTF properties in vivo are found in non-PRK control corneas. In addition, when analyzed for corneas that undergo PRK, they correlate well with well-defined peaks that change in intensity and position over time. According to published data, the PRK-treated cornea shows four peaks arising from the superficial epithelium, the photoablated stromal surface, the spindle-like fibroblast layer, and the endothelium, The non-PRK control cornea shows three peaks arising from the superficial epithelium, basement membrane, and endothelium one week after PRK. It is expected that after 1 week of PRK there is not much difference between the two experimental groups. Two weeks after PRK, the experimental PRK HA group shows an increasing peak intensity near the photoablated stromal surface due to the progression of cell migration of spindle-like fibroblasts. However, the intensity of regrowth fibroblasts (by peak height) is expected to be greatly reduced in the experimental PRK HC-HA / PTX3 group. During the period from 3 weeks to 4 months after PRK, the peak corresponding to the layer of spindle-like fibroblasts is due to the completion of cell-free anterior stroma regrowth in the experimental PRK HA group. Combined with the peaks arising from the photoablated stromal surface, this results in a dramatic increase in the reflectivity of the peak corresponding to the photoablated stromal surface. In contrast, there is no such dramatic increase in reflectance in the experimental PRK HC-HA / PTX3 group. Such light reflectance differences can also be quantified by calculating the area of the CMTF peak that results from a particular intracorneal structure. It is expected that the experimental PRK HA group will show a substantial linear increase in reflectivity intensity and then a slow linear decrease in reflectivity within the first 2-3 weeks after PRK. In contrast, it is expected that there will be a significant decrease in the reflectivity of the experimental PRK HC-HA / PTX3 group in both periods. Taken together, these CMTF data support that the HC-HA / PTX3 complex exerts an inhibitory effect on keratocyte activation, migration and cell recruitment during cell-free anterior stroma regrowth This explains why corneal light scattering (turbidity) is reduced similar to previously reported anti-TGF-β antibodies. As a result, there is little cellularity and reflexivity of activated, migrating, interstitial wound-healing corneal parenchymal cells, little deposition of new stromal extracellular matrix, and normal in the anterior stroma Quiescent keratocyte populations are established faster. This conclusion is based on the fact that activated keratocytes (cells expressing keratocan) in the experimental PRK HC-HA / PTX3 group as compared to the experimental PRK HA group during a period of 2 to 3 weeks after PRK. F-actin), fibroblasts (cytoplasmic staining of S-100A4, cell membrane expression of ED-A fibronectin), and myofibroblasts (nuclear expression of S100A4 and cytoplasmic expression of α-SMA). The Also, in the PRK HC-HA / PTX3 group, it is expected that there will be a significant decrease in the distance between basal epithelial cells and DTAF stained corneal tissue, when compared to the PRK HA group, It shows that there is considerably less fibrous tissue.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 17: Use of HC-HA / PTX3 for the treatment of atherosclerosis In this example, the HC-HA / PTX3 complex produced by the methods described herein is atherosclerosis. For the treatment of

  Atherosclerosis involves the involvement of inflammatory cell populations, particularly macrophages. Macrophage phenotypic transition is observed during disease progression. In atherosclerosis, circulating monocytes are recruited to the site of accumulation of fatty deposits in the intima and subintima of blood vessels via CCR2 and endothelial adhesion-mediated mechanisms. After arrival, these cells become activated and differentiate into macrophages. Later, the fatty deposits begin to mature into plaques with inflammatory cells, continued mobilization of smooth muscle cells, and production of extracellular matrix. The early infiltrating macrophage population in early atherosclerosis is heterogeneous but has a predominantly M2-like phenotype. Concurrently with the progression and expansion of the lesion, a dominant conversion of the M1 phenotype has been observed. This phenotypic conversion may be due to phagocytosis of excess oxidized low density lipoprotein (LDL) in the plaque by macrophages and production of IFN-γ by local Th1 cells, resulting in Leading to the development of foam cell macrophages. Foam cell macrophages exhibit a highly activated phenotype that leads to the production of pro-inflammatory mediators and MMPs that destabilize plaque, which potentially leads to thromboembolism. Treatments that prevent M2 to M1 conversion or selectively deplete M1 macrophages are treatments of clinical utility for the stabilization of atherosclerotic plaques.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject with atherosclerosis. HC-HA / PTX3 complexes are utilized to coat implantable medical devices, such as stents, for example, for implantation at or near the site of inflammation. Treatment of atherosclerosis with the HC-HA / PTX3 complex is expected to reduce inflammation and prevent thromboembolism.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 18: Use of HC-HA / PTX3 for the treatment of obesity and insulin resistance In this example, the HC-HA / PTX3 complex produced by the methods described herein is And for the treatment of insulin resistance.

Adipose tissue macrophages (ATM) contain a significant proportion of cellular components of lean and obese adipose tissue. In normal humans, ATM accounts for as much as 10 percent of the cellular components of the tissue. In comparison, in obese subjects, the figure increases to 40%. In normal, non-obese subjects, ATM has a polarized M2 phenotype characterized by increased baseline STAT6 and PPAR-γ expression. These cells play an important and beneficial role in nutrient metabolism. PPAR-γ deficiency leads to impaired M2 macrophage function and susceptibility to diet-induced inflammation and insulin resistance.
In contrast, ATM that accumulates in adipose tissue during obesity has a strongly polarized pro-inflammatory M1 phenotype. These cells produce high levels of TNFα, IL-6, and IL-1β, all of which are also observed at increased levels of adipose tissue from insulin resistant individuals. High levels of pro-inflammatory mediators locally reduce the function of the endogenous insulin processing cells.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject suffering from obesity or insulin resistance. The HC-HA / PTX3 complex is administered, for example, as a gel solution for treatment. Treatment with the HC-HA / PTX3 complex is expected to promote adipose tissue macrophage (ATM) phenotype transformation from the pro-inflammatory M1 phenotype to the M2 phenotype and restore normal insulin processing .

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 19 Use of HC-HA / PTX3 for the Treatment of Type 1 Diabetes In this example, the HC-HA / PTX3 complex produced by the methods described herein is used to treat type 1 diabetes. Be administered for.

  Diabetes mellitus type 1 (type 1 diabetes, T1DM, IDDM, or earlier juvenile diabetes) is a form of diabetes mellitus resulting from the autoimmune destruction of beta cells secreting pancreatic insulin. The subsequent lack of insulin leads to increased blood and urine glucose. Typical symptoms are polyuria (frequent urination), polydipsia (increased thirst), overeating (increased hunger), and weight loss.

  HC-HA / PTX3 complexes produced by the methods described herein are microcapsules containing cells secreting autologous or allogeneic insulin coated with HC-HA / PTX3 complexes Administered to a subject suffering from type 1 diabetes. Microcapsules are administered to a subject, for example, by infusion. Treatment with HC-HA / PTX3 coated microcapsules allows secretion of insulin released in the subject, preventing or reducing cell therapy or inflammatory response to the microcapsules, thereby allowing type 1 Expected to reduce diabetes and its symptoms.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 20: Use of HC-HA / PTX3 for the treatment of fibrosis In this example, the HC-HA / PTX3 complex produced by the methods described herein is a fibrosis or fibrotic disorder. For the treatment of

  Progressive fibrotic diseases such as idiopathic pulmonary fibrosis (IPF), liver fibrosis and systemic sclerosis are tightly regulated by macrophages. “Profibrotic” macrophages produce a variety of mediators, including TGFβ1, PDGF and insulin-like growth factor 1, which exhibit M1 properties and directly activate fibroblasts and myofibroblasts, which Control ECM deposition. Profibrotic macrophages also produce MMP, TIMP, and IL 1β. IL-1β stimulates TH17 cells to produce IL 17, an important inducer of bleomycin-induced pulmonary fibrosis, a fibrotic disorder with features similar to those of IPF. Production of IL10, RELMα and ARG1 by M2-like macrophages suppresses fibrosis.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject suffering from fibrosis or a fibrotic disorder. The HC-HA / PTX3 complex is administered, for example, as a solution, gel, or as a coating on an implantable medical device. Treatment with the HC-HA / PTX3 complex reduces M1 macrophages and activation of fibroblasts and myofibroblasts and increases the amount of M2 macrophages present at the affected site of the subject Expected, thereby reducing fibrosis and its symptoms, such as scarring.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 21 Use of HC-HA / PTX3 for the Treatment of Chronic Inflammation In this example, the HC-HA / PTX3 complex produced by the methods described herein is chronic, such as rheumatoid arthritis. Administered for the treatment of inflammatory diseases.

  Many autoimmune diseases, including rheumatoid arthritis, involve an inflammatory response to autoantibodies that activates Fc receptors, causing mast cell and macrophage activation and neutrophil infiltration. This leads to a severe local inflammatory reaction that, if not resolved, leads to tissue damage over time through a repair and destruction cycle. In rheumatoid arthritis, CSF1 is constitutively produced by synovial fibroblasts and recruits monocytes and macrophages that invade tissues. Furthermore, locally generated CSF1 together with RANKl induces the differentiation of monocytes into osteoclasts, which causes bone loss.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject suffering from a chronic inflammatory disease, such as rheumatoid arthritis. The HC-HA / PTX3 complex is administered, for example, as a solution, gel, or as a coating on an implantable medical device. Expected to treat HC-HA / PTX3 suppresses M1 pro-inflammatory macrophages, induces neutrophil apoptosis, and inhibits osteoclast differentiation, thereby treating inflammatory diseases and symptoms thereof Is done.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 22 Use of HC-HA / PTX3 for the Treatment of Acute Inflammatory Response In this example, the HC-HA / PTX3 complex produced by the methods described herein is used for myocardial infarction, stroke or Administered for the treatment of acute inflammatory reactions caused by diseases such as sepsis. The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject having an acute inflammatory response caused by a disease such as myocardial infarction, stroke or sepsis. The HC-HA / PTX3 complex is administered as a solution, for example, by intravenous injection. It is expected that the HC-HA / PTX3 complex will reduce or prevent damage caused by acute inflammation by inhibiting M1 inflammatory macrophages.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 23: Use of HC-HA / PTX3 for the treatment of cancer In this example, the HC-HA / PTX3 complex produced by the methods described herein is administered for the treatment of cancer. Is done.

  The involvement of large amounts of inflammatory cells in tumor development and progression is observed, which is commonly described as “smolding inflammation”. These observations led to an established link between inflammatory cells and macrophages, especially cancer. Oncogene development was first thought to have resulted in a hallmark microenvironment of cancer, in which transformed cells promote tissue development, prevent apoptosis, and are cytotoxic Secretes cytokines and chemokines that suppress the immune response (referred to as the “endogenous pathway”). It is now recognized that there are alternative pathways leading to tumorigenesis. This “exogenous pathway” is initially characterized by an inertial pro-inflammatory environment that results from persistent microbial infection, autoimmune disease, or other etiology of unknown origin. Inertial production of large amounts of inflammatory mediators in these cases can lead to tumor cell growth and survival, or induction of genetic instability in normal cells, resulting in oncogene expression and immunosuppression Leading to the production of sex cytokines. Thus, early tumor development is characterized in many instances by a polarized, inflammatory, M1-like macrophage environment.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject with solid tumor cancer. The HC-HA / PTX3 complex is administered, for example, as a solution, gel, or as a coating on an implantable medical device for topical, infusion, or implantable use. Because HC-HA / PTX3 can suppress the polarization of M1 macrophages, treatment with HC-HA / PTX3 is expected to inhibit or prevent its progression to cancer or late phenotype.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 24: Use of HC-HA / PTX3 for the treatment of non-healing skin wounds or ulcers In this example, the HC-HA / PTX3 complex produced by the methods described herein is Administered for the treatment of non-healing skin wounds or ulcers.

  A non-healing skin wound or ulcer that exists for a period of about 3 to 4 weeks without healing is called a non-healing ulcer. Diseases that commonly cause non-healing are vascular disease, diabetes, skin cancer and some infections.

  The HC-HA / PTX3 complex produced by the methods described herein is administered to a subject having a non-healing skin wound or ulcer. The HC-HA / PTX3 complex is administered in solution, topically as a gel, or subcutaneously, for example, for treatment at the site of a wound or ulcer. Treatment with HC-HA / PTX3 is expected to promote wound or ulcer healing by promoting the M2 phenotype of wound healing and tissue regeneration macrophages.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 25: Use of HC-HA / PTX3 for the treatment of high-risk corneal transplants In this example, HC-HA / PTX3 is administered for the treatment of high-risk corneal transplants. Mafia mice in which EGFP + macrophages are injected intramatrix with LPS (5 μg in one eye) for both eyes. In each eye, the OS (oculus sinister; left eye) is treated with PBS (2 or 4 injection sites), while the OD (oculus descriptor, right eye) is immediately after LPS injection. Are treated once with HC-HA / PTX3 (2 or 4 injection sites; 5 μl of 1 mg / ml HA composition containing HC-HA / PTX3 per injection site). Whole cornea images are obtained by in vivo biomicroscopy on day 1, day 2, day 3, day 4, day 5, day 6 and day 7. EGFP positive cells are counted based on the intensity of green fluorescence to determine the level of EGFP infiltration. In a mouse model of corneal transplantation, injection of HC-HA / PTX3 into the subconjunctival site reduces inflammation (ie macrophage infiltration) and improves transplanted cornea survival when compared to PBS vehicle controls. Expected.

  In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is an isolated natural HC-HA / PTX3 complex (nHC-HA / PTX3). is there. In some examples, nHC-HA / PTX3 is isolated from umbilical cord tissue. In some examples, nHC-HA / PTX3 is isolated from amniotic membrane. In some examples, the HC-HA / PTX3 complex used in the methods of treatment described herein is a reconstituted HC-HA / PTX3 complex (rcHC-HA / PTX3).

Example 26: Distribution of HA, PTX3, TSG-6, HC1, HC2, HC3 and bikunin in the umbilical cord (UC)
In this example, in vivo partitioning of HA, PTX3, TSG-6, HC1, HC2, HC3 and bikunin was detected in the umbilical cord (UC) by immunostaining. Tissue frozen sections of UC were exposed to immunostaining for various components of IαI including HA, PTX3, TSG-6, and HC and bikunin. The UC consists of an epithelial layer, and the stroma consists of the subamniotic layer and three canals, one vein, two arteries (FIG. 20a, with one arterial duct, phase), Walton glue. Consists of qualities. Strong positive HA staining was observed in the UC epithelium, subamniotic layer and Walton's glue, and weak HA staining was observed in the vessel wall (FIG. 20a, HA). HAase digestion resulted in the disappearance of the aforementioned HA staining, consistent with specific staining for HA (FIG. 20a, HA (+ HAase)).

  A strong positive immunostaining of PTX3 was present in Walton's glue and weak PTX3 staining was present in the subamniotic layer and epithelium (FIG. 20a, PTX3). HAase digestion does not enhance PTX3 staining in the subamniotic layer and epithelium (not shown), suggesting that weak PTX3 staining is not due to the masking effect by HA. Positive PTX3 staining was also observed in the endothelium of the canal (not shown) rather than the arterial and venous vessel walls.

  Both TSG-6 and bikunin are present in the entire UC, TSG-6 is mainly present in and near the cell, and more TSG-6 is compared to Walton's glue. It was in the epithelium and subamniotic. HC1 had a localization similar to HA, except that the epithelium and vessel wall had faint HC1 staining. Weakness to staining without HC2 and HC3 (Weak) was present in the epithelium but not in the UC stroma. These results indicated that UC resulted in abundant HA, PTX3, TSG-6, HC1 and bikunin, and imbalance, less HC2 and HC3 when compared to AM. It was determined that UC constitutively expressed the proteins described above and the HC-HA / PTX3 complex.

  Furthermore, PTX3 was present in UC with a different dispersion pattern than that reported in AM. More PTX3 was present in the UC Walton's glue and less PTX3 was present in the epithelium and subamniotic membrane. In contrast, there was more PTX3 in the stromal dense layer in the epithelium and AM. UC had a pattern similar to AM in the following markers: more HA was in the entire interstitium of UC and almost no in the epithelium of UC. This was similar in the HA dispersion pattern at AM. TSG-6 was localized mainly in UC epithelial and subamniotic cells and bikunin was ticketed in the whole UC.

Example 27: Comparison of PBS and GnE extracts obtained sequentially from AM and UC This example shows that the insoluble portion after PBS extraction from AM was added to any PTX3, TSG-6 and IαI. It was determined whether it also contained the HC-HA / PTX3 complex. To ascertain whether there was PTX3, TSG-6 and IαI, the protein was extracted from the insoluble part of AM with 4M GnHCl after PBS extraction. In addition, to detect PTX3, TSG-6, HC and bikunin in these two different extracts, UC with PBS was also extracted sequentially with 4M GnHCl.

  He et al. (2009) J. Org. Biol. Chem. 284: 20136-20146), AM, CH and UC are cold at 1: 1 (g / ml) for AM or 1: 1.5 (g / ml) for UC Homogenized with a blender in PBS and mixed for 1 hour at 4 ° C. The mixture was centrifuged at 48,000 g for 30 minutes at 4 ° C. The supernatant of the PBS extract was designated as AME, CHE and UCE, respectively. In addition, a mixture of Walton gluey from UC was also extracted with PBS, and such an extract was named UJE. The insoluble pellet of AM, CH, UC and UC glue mixture after PBS extraction was washed with 4M GnHCl buffer (100 mM sodium acetate, pH 5.8, 4M GnHCl, 10 mM EDTA, Further extraction was performed with 1% Triton X-100). After centrifugation at 48,000 g for 30 minutes at 4 ° C., supernatants were collected and named AMGnE, CHGnE, UCGnE and UJGnE, respectively. The concentration of HA and protein in each extract was detected by HA ELISA and BCA assay, respectively.

  GnHCl further extracted abundant HA and protein from the insoluble pellet after PBS extraction.

  The concentrations of HA and protein in successive PBS and GnHCl extracts are summarized in Table 1, where the HA / protein ratio was also compared between the two extracts. In general, 4M GnHCl further extracted abundant proteins and HA from insoluble pellets of AM, CH, UC and UC glue mixtures after PBS extraction. The GnHCl buffer extracted more protein than PBS from the insoluble pellet, but extracted less HA. However, UCGnE still contained similar amounts of protein and HA as AME and CHE. That is, UC contained more HA than AM and CH in both PBS and GnHCl extracts.

  Monomers, dimers, and HMW PTX3 were present in higher amounts of UC cell PBS extract compared to AM cells. However, HMW PTX3 was present in higher amounts of GnHCl extract in AM cells.

  Analysis of AME with anti-PTX3 antibody revealed a ˜45 kDa band corresponding to the size of native PTX3 monomer and a HMW band at the bottom of the packed well (FIG. 21A, lane 4). NaOH treatment did not affect the 45 kDa band, but completely removed the HMW band, resulting in an HMW smear of PTX3 (FIG. 21A, lane 5), which is the HC− due to NaOH treatment. A prominent feature of PTX3 in the HA complex, where a 90 kD dimer, but not monomeric PTX3, was detected with or without NaOH treatment (FIG. 21A, lanes 2 and 3). . A PTX3 HMW smear represented a complex formed between PTX3 and HC-HA. CHE had the same pattern of PTX3 bands, but there was less PTX3 smear after NaOH treatment, consistent with the immunostaining results. The placenta extract also had the same results as CHE. Remarkably, PTX3 was present by dimers and HMW smears, with the exception of the monomer at UCE, and its intensity was further increased after NaOH treatment. Like AME, UCE created more HMW smearing patterns than AME. These results indicated that UCE contained more PTX3 than AME, while CHE and placental extract contained little PTX3.

  Compared to AME (FIG. 21A), AMGnE shows strong HMW PTX3 smear, weak dimer, and PTX3 monomer levels, and the intensity of HMW PTX3 smear is further increased after NaOH treatment (FIG. 21 B, lanes 3 and 4), indicating that AMGnE contained more HMW PTX3 than AME. More PTX3 was present in the water-insoluble part of AM. CHGnE had only the HMW band in the filled well, not the HMW PTX3 smear, with or without treatment with NaOH. Except that the intensity of PTX3 smear was slightly weaker than that in AMGnE (FIG. 21B, lanes 3 and 4), UCGnE and UJGnE showed the same PTX3 pattern as AMGnE with or without NaOH treatment. Had. The strength of PTX3 smear in UCGnE is also lower than that in UCE, indicating that UCGnE contained less HMW PTX3 than UCE; that is, more PTX3 in the water-soluble portion of UC Were present.

  The above results indicated that both AM and UC contained HMW PTX3. In AM, more HMW PTX3 is water-insoluble and can be extracted by GnHCl after PBS extraction, while more HMW PTX3 in UC, which can be extracted mainly by PBS, is water-soluble. It was.

  Both IαI and HC1 are mainly in the AM PBS extract, whereas in UC most IαI is in the PBS extract, while HC1 is in the GnHCl extract, but more bikunin is present. It is not different from the other two extracts and is present in UCGnE rather than UCE.

  FIG. 22 shows that an 80 kDa HC1 band was present in all PBS extracts except UCE and in all GnE extracts except AMGnE. This band is increased by NaOH in all PBS extracts but not GnE, which is the same as AM by Zhang et al. (2012) J. Org. Biol. Chem. 287: 12433-12444, containing both free and bound water-soluble HC1 released by NaOH (ie, ester bound to HA in HC-HA and to bikunin in IαI). It shows that. UC contains water-soluble bound HCl released by NaOH and is also separated into water-insoluble extracellular components that were separated by SDS and 2-ME but not affected by NaOH. It also contained bound, water-insoluble free HCl. This was consistent with a strong positive HC1 staining in UC. The HMW HC1 band was present in all PBS and GnHCl extracts in filled wells and was reduced by NaOH, indicating that this was an HC-HA complex. The HMW HC1 band was weaker in UCGnE than UCJGnE, indicating that the Walton glue-like substance contained more water-insoluble HC-HA complex. Released IαI was found in all PBS extracts, but not all GnE extracts, suggesting that it was water soluble. However, free PαI was found in all PBS and GnHCl extracts, suggesting that PαI had a different effect than IαI. More bikunin was found in UCGnE than UCE, with no difference between the other two extracts, which most bikunin bound to other water-insoluble molecules in UC, which displayed a unique function I emphasized what I was doing.

  TSG-6 was present in the AM HMW complex but not the UC GnHCl extract.

  FIG. 23 shows that the 35 kDa TSG-6 band reported in AME (Zhang et al. (2012) J. Biol. Chem. 287: 12433-12444) is not in all other extracts but in AMGnE. It was present, indicating that TSG-6 was not present in UC GnE. This band is unaffected by NaOH, confirming that TSG-6 was not bound to HMW species that could be cleaved by NaOH. However, the HMW TSG-6 band was found in AMGnE and CHGnE but not UCGnE and UJGnE. Furthermore, this band was not altered by NaOH, indicating that TSG-6 was strongly bound to the HMW species. TSG-6 is not detected in HC-HA purified by 4X ultracentrifugation from GnE, which means that TSG-6 is still bound in the insoluble matrix, but by GnHCl during ultracentrifugation. It suggests that it can be separated.

  In summary, GnHCl further extracted abundant HA and protein from the insoluble part of AM and UC after PBS extraction. UC contained more HA than AM and CH in both PBS and GnHCl extracts. HMW PTX3 was higher in the AM GnHCl extract and higher in the UC PBS extract. More HMW PTX3 was retained in the insoluble part after PBS extraction. HC1 was mainly in the AM PBS extract, not the UC GnHCl extract. HMW TSG-6 is in AMGnE but not UCGnE and UJGnE, indicating that TSG-6 was still bound in an insoluble matrix and could be separated by GnHCl during ultracentrifugation. Yes.

Example 28: Purification of HC-HA complex by four successive ultracentrifugations from extracts of AM and UC PBS, and presence of PTX3, HC, bikunin, and TSG-6 in the HC-HA complex In this example, the HC-HA complex was purified from AME and UCE by four successive ultracentrifugations, and in addition to HC, bikunin and TSG-6, the presence of PTX3 was detected by Western blot. And detected in the complex of UC HC-HA.

4 ^th AM HC-HA complex is contained more HMW PTX3 and ^HC1, it was pure than HC-HA complexes of ^{2 nd} and ^{3 rd.}

With anti-PTX3 antibody, Western blot analysis of AM HC-HA of ^{1-4 th} as compared to the monomer found in PBS extract showed a band (dimer) of 90 kDa. This indicates that the dimer state was resolved by further extraction in 4M GnHCl by ultracentrifugation, thereby allowing the top in the 1 ^st , 2 ^nd , 3 ^rd and 4 ^th HC-HA complexes. The HMW band at the top of the gel is revealed (Fig. 24a). Compared to the purified PTX3 control, the 90 kDa band was a PTX3 dimer and the high molecular weight band was an HC-HA complex containing PTX3. HAase after treatment, the band of 90 kDa, did not change at all HC-HA complex, the band of HMW smear ^was vaguely detected in fractions ^{3 rd} and ^{4 th.} That is, from 1 ^st to 4 ^th , the HMW band gradually disappeared and smear gradually appeared, which was further enhanced by the 4 ^th HC-HA complex. There was no 45 kDa PTX3 monomer band in all HC-HA complexes. As a result, the HC-HA complex contains a multimeric form of PTX3 capable of binding to HC-HA, and the number of ultracentrifugation increases, and the HC-HA complex containing PTX3. Was more purified. The presence of a 90 kDa PTX3 dimer in the HC-HA complex with or without HAase showed the following: 1) PTX3 dimer present in HC-HA was separated by SDS and 2-ME 2) HMW PTX3 was resistant to SDS and 2-ME. The PTX3 dimer, the product by 2ME, is further confirmed below (FIG. 24a).

Using an anti-HC1 antibody, an 80 kDa HC1 band was detected from all four HC-HA complexes only in the initial 1 ^st and 2 ^nd fractions (FIG. 24b). After HAase treatment, the HC1 band was enhanced and several smaller bands also appeared in the 1 ^st to 3 ^rd HC-HA complex. The results indicated that the purified HC-HA complex did not contain free HC and HC-HA was made with HC1. Consistent with the above PTX3 Western blot results, the number of ultracentrifugation increased and the HC-HA complex was more purified. In all HC-HA complexes, HC2 (FIG. 24c), HC3, and TSG-6 (FIG. 24d) were not found.

  TSP-1 was present only in the AM GnHCl extract, not the PBS extract and 1-4th HC-HA complex.

Thrombospondin-1 (TSP-1) was only detected as a trimer in the AM GnHCl extract, but not in the PBS extract and 1-4 ^th HC-HA complex (FIG. 25). . After HAase treatment, it appears as a smear, indicating that TSP-1 is insoluble water and is strongly bound to HC-HA. However, binding to HC-HA in such an insoluble matrix can be separated by GnHCl and CsCl.

Like the 4 ^th AM HC-HA complex, the 4 ^th UC HC-HA complex contains PTX3 and HC1, but not HC2, HC3, bikunin and TSG-6, and due to the lack of 2ME, No mer was produced, but HC1 was provided.

Western blot analysis of 4 ^th UC HC-HA with or without HAase treatment using anti-PTX3 antibody showed that the PTX3 band in the 4 ^th AM HC-HA complex (FIG. 26a, lanes 3 and 4). A pattern of the PTX3 band in the 4 ^th UC HC-HA complex (Fig. 26a, lanes 5 and 6) similar to the pattern of was shown. When the sample buffer did not contain 2-ME, the 90 kDa PTX3 dimer disappeared in the UC HC-HA complex with or without HAase (FIG. 26a, lane 7). And 8), indicating that the appearance of the 90 kDa PTX3 dimer in the HC-HA complex was due to a decrease in PTX3 bound to HC-HA by 2-ME in the sample buffer. ing. Using the anti-HC1 antibody, only the high molecular weight HC-HA band was detected in the 4 ^th UC HC-HA complex, similar to the detection in the 4 ^th AM HC-HA complex (FIG. 26b, lane 4). (B in FIG. 26, lane 6). After HAase, the HC-HA band disappeared and the HC1 band increased as in the 4 ^th AM HC-HA complex (lane 5) (lane 7), but its intensity was in 4 ^th AM HC-HA. It was a little weaker than. This indicated that HC1 formed a complex of PTX3 and SS. When the sample buffer did not contain 2-ME, a strong band appeared with a slightly higher MW than generic HC1, indicating that HC1 was linked to PTX3 via SS. Is shown. In 4 ^th AM and UC HC-HA complex, HC2, HC3 (c in FIG. 26), (e in FIG. 26) bikunin (d in FIG. 26) and TSG-6 was not detected.

Example 29: Purification of HC-HA complexes from total AM and UC GnHCl extracts by 4 successive ultracentrifugations and comparison of PBS extracts. This example shows more HC-HA complexes Was obtained from AM and UC and the HC-HA complex had a more rational composition of PTX3 and HC-HA, and it had a more effective therapeutic role in the clinic I decided that. AM and UC were extracted with 6 M GnHCl buffer (200 mM Tris-HCl, pH 8.0, 6 M GnHCl, 10 mM EDTA, 10 mM aminocaproic acid, 10 mM N-ethylmaleimide, 2 mM PMSF): AM And GnHCl extraction from UC was performed by adding 6 M GnHCl buffer to AM and UC powder at 1: 4 (g / ml). Samples were mixed overnight at 4 ° C. and centrifuged at 48,000 g for 30 minutes at 4 ° C. The supernatant was a GnHCl extract. The 4 ^th HC-HA complex was purified from the extraction of AM and UC GnHCl using the same procedure as for the purification of 4 ^th HC-HA from the PBS extract. To examine PTX3, HC, bikunin, TSG-6 and possibly other proteins, the HC-HA complex was characterized by Western blotting. HC-HA agarose gels were run to see the contents and molecular weight of the HA.

  GnHCl extracted more HC-HA complexes from AM and UC than PBS.

GnHCl extracts from AM and UC were named AMEG and UCEG, and their HA and protein contents were detected by BCA assay and HA ELISA, respectively. The 4 ^th HC-HA complexes were purified from GnHCl extraction and their HA and protein content were detected as well. Table 2 summarizes the contents and ⁴ th HC-HA complexes of these proteins and HA in both extracts of PBS and GnHCl. The results showed that the AM and UC GnHCl extracts contained more HA and had a higher HA / protein ratio compared to the relative PBS extract. In addition, more HC-HA complex was purified from the GnHCl extract.

AM 4 ^th GnHCl HC-HA complex contained more HC1 and HMW PTX3 with or without treatment with HAase or NaOH, but less than PBS HC-HA, PBS and GnHCl HC-HA Both of them did not contain TSP-1.

  With anti-HC1 antibody, GnHCl HC-HA showed an HMW band in PBS HC-HA in addition to the filled wells, but HAase digestion only released weaker HC1 (FIG. 27a Lanes 6 and 7). NaOH treatment also released a weaker HC1 band with a slightly higher MW than that released by HAase (Fig. 27a, lane 8), which in PBS HC-HA after NaOH treatment. I couldn't see it. These results indicate that GnHCl HC-HA contained HC1, but the amount was less than PBS HC-HA. Similarly, unlike PBS HC-HA, using anti-PTX3 antibody, GnHCl HC-HA does not show significant HMW PTX3 smears with or without HAase digestion and dimer PTX3 Only shown (FIG. 27b, lanes 6 and 7). NaOH also resulted in the appearance of HMW and dimer PTX3. These results indicate that GnHCl HC-HA contained less HMW PTX3 than PBS HC-HA.

  Similar to the HC1 blot, a higher MW dimer of PTX3 occurred after NaOH than HAase in GnHCl HC-HA. These results collectively showed that NaOH can release an ester bond linking HC1 to HA and bind to PTX3. Since GnHCl HC-HA had more HA content than PBS HC-HA, the GnHCl HC-HA complex contained HA that was not bound by PTX3 or HC1, and was consequently purified. Resulted in a reduction in the content of the actual HC-HA / PTX3 complex in the product and less HC1 and HMW PTX3 therein. TSP-1 was not detected in PBS HC-HA by anti-TSP-1. Of course, TSP-1 was also not detected in GnHCl HC-HA. Since the GnHCl extract contained TSP-1, these results indicated that TSP-1 was separated by ultracentrifugation and therefore was not present in GnHCl HC-HA.

  The agarose gel showed abundant HA in GnHCl HC-HA.

PBS HC-HA showed a continuous HA smear from the top filled well to the bottom of the agarose gel, and HAase completely abolished the HA smear (Figure 28, lanes 3 and 4). GnHCl HC-HA showed a HA smear from the band in the packed well and from the 4,570 kDa position to the bottom of the agarose gel (Figure 28, lane 5).
HA in GnHCl HC-HA rested between the filling well and the start of HA smear, but its intensity was stronger than in PBS HC-HA. Furthermore, HAase did not completely nullify HA smear and HMW HA bands in GnHCl HC-HA (FIG. 28, lane 6). The upper fraction from the GnHCl extraction after 4 ^th ultracentrifugation (1-6 fraction) also showed the same HA smear pattern as the “lower fraction” of GnHCl HC-HA (FIG. 28, lanes). 7 and 8). These results show that GnHCl HC-HA contained more HMW HA (having a smaller MW than PBS HC-HA), but the HMW corresponding to the lack of HMW PTX3 smear in the Western blot of GnHCl HC-HA. It was shown that a portion of HA smear was missing. This is because the missing HMW HA smear that was present in PBS HC-HA was at least partially formed by cross-linking of PTX3 and HC-HA, and the HMW HA in the GnHCl HC-HA filled well was It was shown that it was compounded by other components.

  GnHCl HC-HA contained several proteins not found in PBS HC-HA by Coomassie blue staining.

  FIG. 29A shows that bands in the upper filled well, large 140 kDa and several small 70 kDa, doublet 55 kDa and 20 kDa bands were present in the upper fractions of AM GnHCl HC-HA and GnHCl HC-HA. It shows that it was not present in all other PBS HC-HA. This indicated that AM GnHCl HC-HA contained several proteins that were not present in PBS HC-HA. In addition, 90 kDa and 25 kDa bands were also visualized in the upper fraction of GnHCl HC-HA. Since Western blot detected HC1 in PBS HC-HA, HC1 should also be present in PBS HC-HA by Coomassie blue staining. The reason it was not present in PBS HC-HA was due to the fact that the loaded HC-HA did not enter the gel due to overload. 140 kDa was shown as a broad band, suggesting that it contained a sugar moiety. Furthermore, HAase did not affect these bands, indicating that these species were separated by SDS and 2-ME.

  Compared to AM GnHCl HC-HA, UC GnHCl HC-HA showed bands in the top filled well, 90 kDa, 70 kDa, doublet 55 kDa, 35 kDa and 20 kDa (B in FIG. 29, lanes 4 and 5). ). A weak 140 kDa band was also present in it. These bands were not affected by HAase. Furthermore, the upper fraction of GnHCl HC-HA also showed a smear from the upper well to the reduced 200 kDa site after HAase treatment. All bands were absent in UC PBS HC-HA. These results also indicate that UC GnHCl HC-HA also contains some proteins that were absent in PBS HC-HA, and that UC GnHCl HC-HA is an AM GnHCl HC-HA for the protein band they contained. Showed that they were different.

  The above results showed that GnHCl HC-HA differed from PBS HC-HA from both AM and UC in the following ways: (1) GnHCl HC-HA (from Western blot) While containing less HC1 and HMW PTX3 than PBS HC-HA, like PBS HC-HA, TSG-6, HC2 and HC3 were also absent in GnHCl HC-HA. (2) GnHCl HC-HA contained more HMW HA but lacked a piece of HMW HA corresponding to HMW PTX3 smear in Western blotting demonstrated by PBS HC-HA (from agarose gel) It was. (3) GnHCl HC-HA contained several proteins with mainly MW 140 kDa that were not found in PBS HC-HA (from Coomassie blue stained gel).

  In summary, GnHCl extracted more HA and protein from AM and UC tissues, resulting in higher HA / protein ratios compared to PBS extraction. More HC-HA complex (according to HA content) was purified from GnHCl extraction for both AM and UC. GnHCl HC-HA contained HC1 and HMW PTX3 for both AM and UC, but much less in PBS HC-HA. GnHCl HC-HA lacked HMW HA smear species in an agarose gel corresponding to HMW PTX3 smear in Western blotting demonstrated by PBS HC-HA. GnHCl HC-HA contained several proteins found in PBS HC-HA.

Example 30: Determination of identity of an unknown protein band in GnHCl HC-HA complex purified from AM and UC This example is for deglycosylation of or after that after running a SDS-PAGE gel. The identity of the unknown band in GnHCl HC-HA was determined either by CB staining of GnHCl HC-HA from AM and UC or by Western blot analysis. Samples were lyophilized AM and UC 4x HC-HA (containing 30 μg HA) from both PBS and GnHCl extracts. Lyophilized HC-HA was incubated with 50 μl TFMS and 20 μl anisole for 3 hours on ice and neutralized with TFMS with 125 μl N-ethylmorpholine. Samples were precipitated with 5-10 volumes of acetone at -20C overnight or at -80C for 1 hour. Samples were centrifuged and the dried pellet was dissolved in SDS sample loading buffer for electrophoresis. Enzymatic deglycosylation with keratinase (Endo-β-galactosidase) is performed to remove keratan sulfate chains and N-linked oligosaccharides, or enzymatic deglycosylation with chondroitinase (Cabc), This was done to remove chondroitin sulfate chains. HC-HA (containing 30 μg HA) was incubated with 0.1 U / ml keratinase in 50 mM sodium acetate, pH 5.8, for 2 hours at 37 C, or 5 U in PBS for 2 hours at 37 C. Incubated with / ml Cabc. SDS-PAGE gels were run for CB staining testing, followed by Western blot analysis.

  Keratan sulfate and osteoadherin were present in AM GnHCl HC-HA but not PBS HC-HA.

  Western blot analysis was performed. The results are shown as B and C in FIG. Western blot with anti-keratan sulfate antibody showed a broad 70 kDa (60-80 kDa) band in AM GnHCl HC-HA with or without HAase digestion (FIG. 30B, lanes 6-8). ), But not in PBS HC-HA, indicating that this ˜70 kD keratin sulfate proteoglycan was responsible for the positive immunostaining shown in FIG. 30D. This 70 kD band corresponded to the same band noted in GnHCl HC-HA with or without the HAase treatment shown in the Coomassie blue stained gel (FIG. 30A).

  To further determine whether this 70 kD keratin sulfate proteoglycan is SLRP, anti-lumican, anti-fibrojuline, and anti-osteoadherin antibodies were used in Western blots. The anti-osteoadherin antibody recognized a 60 kD band but not a 70 kD band in GnHCl HC-HA with or without HAase digestion (FIG. 30C, lanes 6-8), but PBS HC− Not so in HA. Osteoadherin with a keratin sulfate chain has a molecular weight of ˜80 kD, while its non-keratin sulfate protein is ˜60 kD. A keratin sulfate band at a size of 60 kD was detected, but only at a broad size of 70 kD, which was a 60 kD band detected by anti-osteoadherin was non-keratan sulfate osteoadherin. Showed that. AM GnHCl HC-HA contained non-keratan sulfate osteoadherin tightly bound to HC-HA and was resistant to 4 ultracentrifugations in the presence of 6M GnHCl and cesium chloride. However, it was released by SDS and 2-ME in sample buffer. The results also indicated that the 70 kD keratin sulfate proteoglycan was not osteoadherin. There were no lumicans and fibrojulines detected with GnHCl HC-HA, indicating that the 80 kD proteoglycan is neither lumican nor fibromodulin.

Deglycosylation and analysis of AM GnHCl HC-HA To remove all glycans using keratinase and to remove specific glycans using chondroitinase, HC-HA was purified by TFMSA. Deglycosylated to see if there was a change in the 140 kD and ˜80 kD bands in AM GnHCl HC-HA and to determine if the ˜80 kD keratin sulfate proteoglycan is a keratocan, PRELP or osteoglycan (Osteoglycan) . Coomassie blue staining was performed as a first step to confirm the effect of the above deglycosylation.

  In FIG. 31A, a gel stained with Coomassie blue (CB), AM GnHCl HC-HA (FIG. 31A, lane 2) shows dominant 140 kDa, 70 kDa, doublet 50 kDa, 20 kDa and The same band of the weak 35 kDa band was also shown. K / C / H did not significantly affect these bands except that it resulted in the appearance of large 80 kDa, weak 100 kDa, and 30 kDa bands (FIG. 31A, lane 3). This pattern was similar to that resulting from the upper fraction of AM GnHCl HC-HA under C / K / H (FIG. 31A, lane 6). These results indicate that the 140 kDa, 70 kDa, and 55 kDa bands were not non-keratan sulfated and / or chondroitin sulfated in GnHCl HC-HA released as a large 80 kDa species after C / K / H. It was shown that there were other keratan sulfated and / or chondroitin sulfated proteins. TFMSA treatment led to the disappearance of all the above-mentioned bands except the 20 kDa band, generating a clear new 50 kDa band and HMW smear (FIG. 31A, lane 4). TFMSA / H resulted in a new 25 kDa band that eradicated the smear but did not change the 50 kDa band (FIG. 31A, lane 5). This result indicated that the 140 kDa, 70 kDa, 55 kDa and 80 kDa bands were the same species of 50 kDa with different amounts of glycans.

  To determine if a 50 kDa band originated from the 60 kDa osteoadherin, Western blot analysis was performed using an anti-osteoadherin antibody. The result showed a 60 kDa species in AM GnHCl HC-HA consistent with the result shown in FIG. 31C (FIG. 31B, lane 4). C / K / H did not change its molecular weight (FIG. 31B, lanes 5 and 6), but TFMSA with or without HAase (T / H) treatment made it a less intense 55 kDa species. (Fig. 31, lanes 7 and 8). The upper fraction of AM GnHCl HC-HA with T / H showed a stronger band compared to no T / H, but no smaller mW without intensity change (FIG. 31B, lane 9). And 10). These results further confirmed that AM GnHCl HC-HA contained osteoadherin without keratan sulfate and chondroitin sulfate. The intensity of the osteoadherin band decreased after TFMSA treatment because (1) the protein was degraded by TFMSA; (2) it was blocked by a large amount of other proteins with the same MW released after TFMSA treatment Was the cause. Osteoadherin was undetectable in PBS HC-HA without treatment, but after TFMSA / HAase treatment, a 60 kDa doublet band appeared, indicating that PBS HC-HA was tightly bound to HA. This shows that it contained a trace amount of osteoadherin.

  Western blot with anti-decolin antibody showed very strong broad 140 kDa species (80-160 kDa) and weak doublet 50 kDa species in AM GnHCl HC-HA (FIG. 31C, lane 4; 31D, lane 4). And 5), but not in PBS HC-HA (FIG. 31C, lane 2; 31D, lanes 2 and 3). The broad 140 kDa species corresponded to decorin with one chondroitin sulfate or dermatan sulfate chain and a different number of glycans, while the doublet 50 kDa species tended to correspond to decorin that was less glycosylated. Since HAase was not affected by decorin species, it was shown that it can be released by SDS and 2-ME. The above idea was confirmed by C / H (FIG. 31C, lane 5), which increased the 70 kDa species, and C / H / K, which produced the same results (FIG. 31B, lane 6). Therefore, the 70 kDa species was decorin without chondroitin. This 70 kDa species was a minor component because the large, wide 140 kDa species was not significantly altered by either C / H or C / H / K. TFMSA treatment completely abolished the broad 140 kDa species, while giving rise to large 43 kDa species corresponding to the deglycosylated decorin core protein, and small 95 kDa, 80 kDa and weak 30 kDa species ( FIG. 31C, lane 7). TFMSA / H treatment showed the same species pattern as TFMSA alone, except that the intensity of all these species was enhanced, indicating that decorin was tightly bound to HA. . TFMSA / H also resulted in the release of a weak 43 kDa species from PBS HC-HA, which also contained trace amounts of decorin that AM PBS HC-HA was tightly bound to HA. It is shown that. The upper fraction of AM GnHCl HC-HA with or without TFMSA / H shows the same pattern as the lower fraction with stronger intensity than the latter (FIG. 31C, lanes 9 and 10). It was shown that the fraction also contained abundant decorin. The above results indicated that large 140 kDa, 70 kDa, and doublet 50 kDa species in CB-stained gels are formed by decorin via CS, primarily non-CS and non-KS.

  Unlike decorin, Western blots with anti-biglycan antibodies showed HMW smears with one strong region at 400 kDa, and weak 45 kDa species in AM GnHCl HC-HA with or without HAase. Shown (FIG. 31E, lane 4; 2F, lanes 4 and 5), but not in PBS HC-HA (FIG. 31D, lane 2; F, lanes 2 and 3). While the 45 kDa species corresponded to the biglycan core protein, the HMW smear was a glycosylated biglycan with two chondroitin sulfate or dermatan sulfate chains. HAase enhanced the 400 kDa region with less HMW smear above 400 kDa, indicating that some biglycan was also bound to HC-HA. C / H or C / K / H did not significantly change the HMW smear and 45 kDa species but increased the 70 kDa species, which was probably a chondroitin-free biglycan (FIG. 31E, lanes 5 and 6). . Most biglycan in AM GnHCl HC-HA did not bind to CS or KS because the amount of 70 kDa species was very small and large HMW smears were not significantly altered by the treatments described above. TFMSA treatment completely abolished the HMW smear, resulting in a large 45 kDa species corresponding to the deglycosylated decorin core protein and a weak 95 kDa, 80 kDa and 30 kDa species (FIG. 31E, lane 7). Suggested the presence of biglycan in AM GnHCl HC-HA. The 95 kDa and 80 kDa species were partially deglycosylated biglycan, while the 30 kDa species was degraded biglycan. TFMSA treatment in combination with HAase treatment showed the same species pattern as TFMSA alone, except that the intensity of all these species was enhanced, indicating that biglycan was tightly bound to HA. Show. The upper fraction of AM GnHCl HC-HA with or without TFMSA / HAase shows the same pattern as the lower fraction with stronger intensity than the latter (FIG. 31E, lanes 9 and 10). It was shown that the fraction also contained abundant biglycan. Western blot analysis with anti-keratan sulfate antibodies revealed the presence of a 70 kDa keratan sulfate protein in AM GnHCl HC-HA with or without keratinase or chondroitinase treatment without altering the size of the molecule (Figure 31G), suggesting that keratinase did not completely remove keratan sulfate, or that the amount of KS was trace in this species. Western blots with anti-PTX3 antibody showed K in AM GnHCl HC-HA and K / H compared to those with or without digestion of HAase alone (FIG. 31G, lanes 4 and 5). Increased and increased HMW PTX3 smears were shown (Figure 31H, lanes 6 and 8). Chondroitinase had no such effect, indicating that some KS-containing species were bound to PTX3 in GnHCl HC-HA. The same results were obtained from Western blot analysis of UC GnHCl HC-HA with or without keratinase digestion (see FIG. 32G below). Western blot confirmed the absence of fibromodulin, lumican, keratocan, PRELP, osteoglycine, epiphycan, periostin and TSG-6 in addition to bikunin in AM GnHCl HC-HA.

  In summary, AM GnHCl HC-HA contained abundant decorin and biglycan bound to HC-HA, whereas PBS HC-HA contained only weak decorin and no biglycan. . While AM GnHCl HC-HA contained species containing osteoadherin and keratan sulfate, PBS HC-HA did not. Very small amounts of decorin and biglycan in AM GnHCl HC-HA contained chondroitin sulfate chains.

  Deglycosylation and analysis of UC GnHCl HC-HA showed that decorin and biglycan were abundant in UC GnHCl HC-HA but not PBS HC-HA. Keratan sulfate, osteoadherin and bikunin were also present in UC GnHCl HC-HA.

  CB staining (FIG. 32A) showed the same bands of 160 kDa, 90 kDa, 70 kDa, doublet 50 kDa, 35 kDa and 20 kDa bands in the upper filled wells in UC GnHCl HC-HA (FIG. 32A (lane 4)). C / H or C / H / K did not significantly affect these bands, except that it resulted in the appearance of large 80 kDa and weak 30 kDa bands (FIG. 32A, lanes 5 and 6). . TFMSA treatment decreased all the above bands except the 20 kDa band, but increased the large 50 kDa band, the small 80 kDa band and the HMW smear (FIG. 32A, lane 7). TFMSA / H resulted in a weak 25 kDa band that disappeared smear and the 80 kDa band but appeared and reduced the intensity of the newly formed 50 kDa band (FIG. 32A, lane 8). . These results were similar to those obtained from AM GnHCl HC-HA (FIG. 31A), indicating that UC GnHCl HC-HA had a similar configuration to AM GnHCl HC-HA. Is shown. The upper fraction of UC GnHCl HC-HA with or without TFMSA / H shows the same pattern as the lower fraction (Figure 32A, lanes 9 and 10), which is the same component as the lower fraction. It was shown that it had. UC PBS HC-HA without deglycosylation showed a HMW band in and below the filled wells as well as a 20 kDa band. TFMSA / H abolished the HMW band but mainly increased the 50 kDa band other than the weak 80 kDa and 25 kDa bands, which showed that UC PBS HC-HA was released by complete deglycosylation and HA degradation. Suggesting that it contained only some glycosylated proteins.

  Western blot analysis with anti-decolin antibody showed a broad 160 kDa species in UC GnHCl HC-HA with or without HAase (FIG. 32B, lanes 4 and 5), but with PBS HC-HA Not shown (FIG. 32B, lanes 2 and 3), indicating that UC GnHCl HC-HA contained decorin, like AM GnHCl HC-HA. Its molecular weight was different from that in AM GnHCl HC-HA due to different levels of glycosylation. HAase significantly reduced the 160 kDa species, indicating that it was bound to HC-HA. Keratinase with or without HAase also reduced the intensity of the 160 kDa species, indicating that it contained some KS. Remarkably, C with or without HAase digestion led to the disappearance of 160 kDa species and upper well species, but gave rise to 50 kDa and 90 kDa species as well as HMW smears, which It was shown that decorin in GnHCl HC-HA was mainly chondroitin sulfate compared with decorin in AM GnHCl HC-HA, and they contained less androidal sulfate chains. These results show that UC GnHCl HC-HA contains decorin, and that decorin in UC is (1) glycosylated, (2) the type of glycosaminoglycan attached, and (3) the overall amount of AM. Further confirmed that it was different.

  Western blots with anti-biglycan antibodies showed strong HMW species in the upper wells, HMW smears in the 400 kDa region and 140 kDa region, and 45 kDa species in UC GnHCl HC-HA with or without HAase. (FIG. 31C, lanes 4 and 5), this was not the case with PBS HC-HA (FIG. 31C, lanes 2 and 3). HAase enhanced the 400 kDa region without affecting the HMW species in the wells, suggesting that some species were tightly bound to HA. Keratinase with or without HAase did not significantly change the above-mentioned species except that it reduced the 45 kDa species (FIG. 32C, lanes 6 and 8), indicating that the 45 kDa species had KS. Contained, but most others suggest not. Chondroitinase alone abolished the HMW species in the upper well and decreased the intensity of the 400 kDa region, but increased the strong broad 50 kDa, 100 kDa and 28 kDa species with smear between them. (FIG. 32C, lane 7). Chondroitinase + HAase had the same result, the whole smear was more enhanced and the 28 kDa species disappeared (FIG. 32C, lane 9). These results suggested that, similar to decorin, biglycan in UC GnHCl HC-HA mainly leads to chondroitin sulfate chains. This result is different from that in AM HC-HA with less sulfation of chondroitin. Most biglycans also form HMW complexes in HC-HA and some bind to HC-HA.

  Western blot with anti-bikunin antibody showed a broad 35 kDa band in UC GnHCl HC-HA with or without HAase digestion, but not in PBS HC-HA (FIG. 32D, lane 4). And 5). The 35 kDa band corresponds to the natural MW of bikunin. Keratinase with or without HAase sharpened this 35 kDa band but did not change its MW (Figure 32D, lanes 6 and 8), while chondros with or without HAase digestion. Itinase converted 35 kDa bikunin to 25 kDa core bikunin (FIG. 32D, lanes 7 and 9), indicating the presence of bikunin in UC GnHCl HC-HA and, as reported, containing CS. This is further confirmed. HMW smears were also formed after chondroitinase treatment, suggesting that bikunin is tightly bound to HC-HA via CS. These results were different from AM GnHCl HC-HA which did not contain bikunin.

  Western blots with anti-PTX3 antibody showed UC GnHCl after H, K, C and especially at K / H compared to those with or without HAase digestion (FIG. 32E, lanes 4 and 5). An increased HMW PTX3 smear in HC-HA was shown (Figure 32E, lanes 6 and 8). These results confirmed the presence of HMW PTX3 in UC GnHCl HC-HA and its strong binding in GnHCl HC-HA. Furthermore, such strong binding is further facilitated by the presence of a species containing KS, whose identity remains unclear. It is also explained that our previous data (without enzymatic digestion) may have seen too little HMW PTX3 in UC GnHCl HC-HA.

  Western blot with anti-keratan sulfate antibody showed a weak 55 kD band in HMW species in wells and UC PBS HC-HA. HAase did not change this band, but made the 60 kDa band more apparent (Figure 32F, lanes 2 and 3). However, a 140 kD band was recognized by anti-keratan sulfate antibody in UC GnHCl HC-HA with or without HAase digestion (FIG. 32F, lanes 4 and 5). Keratinases with or without HAase treatment did not eliminate the 140 kDa band, but some of them, including mainly the 35 kDa band and the 60 kDa and 55 kDa bands found in PBS HC-HA Other bands were increased (Figure 32F, lanes 6 and 8).

  Chondroitinase with or without HAase treatment also did not eliminate the 140 kDa band, but also increased the 90 kDa band, similar to the 60 kDa and 55 kDa bands found in PBS HC-HA (FIG. 32F, Lanes 7 and 9). Chondroitinase treatment also resulted in the appearance of a reduced HMW smear after HAase treatment, which indicates that UC GnHCl HC-HA contains abundant chondroitin sulfated proteins other than keratan sulfated proteins. It suggests that. It is clear that the protein of keratan sulfation in UC GnHCl HC-HA (140 kDa) had a different MW from that in AM GnHCl HC-HA (˜80 kDa), which is a different amount in the chain. Glycan may be the cause.

  Using an anti-osteoadherin antibody, a large 60 kD band and a weak 80 kD band were detected in UC GnHCl HC-HA but not PBS HC-HA (FIG. 32G, lane 4). These two bands were not clearly affected by keratinase or chondroitinase or HAase. 80 kD should be keratin sulfated osteoadherin, while ˜60 kD should be non-keratin sulfated osteoadherin. The results suggested that UC GnHCl HC-HA contained both keratin sulfated and non-keratin sulfated osteoadherins.

  In summary, fibromodulin, lumican, keratocan, PRELP, osteoglycine, epiphycan, periostin and TSG-6 were not detected in UC GnHCl HC-HA. UC GnHCl HC-HA contained decorin, biglycan, osteoadherin, keratan sulfate and bikunin. Biglycan and decorin were abundant, while PBS HC-HA was not rich in these species.

Summary HC-HA complexes were purified from both AM and UC PBS and GnHCl extractions by 4x ultracentrifugation. HC-HA purified from GnE was significantly different from HC-HA purified from PBS extraction in yield and chemical structure (see Table 1). In quantity, HC-HA purified from GnE contained more HA than that purified from PBS. In chemical structure: GnHCl HC-HA contained more HMW HA (slightly smaller MW than PBS HC-HA), but in Western blotting demonstrated by PBS HC-HA (from agarose gel) The piece of HMW HA corresponding to the HMW PTX3 smear was lacking. With or without HAase digestion, GnHCl HC-HA contained less HC1 and HMW PTX3 than PBS HC-HA, but after digestion of keratinase + HAase, more PTX3 (Western Detected from the blot), suggesting that HMW PTX3 was tightly bound to keratan sulfated protein in GnHCl HC-HA. Neither PBS HC-HA nor GnHCl HC-HA contained TSG-6, HC2 and HC3. Bikunin was present in UC GnHCl HC-HA, but not in UC PBS HC-HA, and in both AM PBS and GnHCl HC-HA. AM GnHCl HC-HA was relatively more abundant than UC GnHCl HC-HA and contained abundant decorin. Both AM and UC PBS HC-HA contained a slight amount of decorin. AM and UC GnHCl HC-HA contained abundant biglycans, especially in UC GnHCl HC-HA. There was no biglycan in PBS HC-HA. AM and UC GnHCl HC-HA contained osteoadherin. AM and UC PBS HC-HA did not contain biglycan, a species containing keratan sulfate, fibromodulin, lumican, keratocan, PRELP, osteoglycine, epiphycan, periostin, and osteopontin, TSP-1. In AM and UC GnHCl HC-HA, there were no fibromodulin, lumican, keratocan, PRELP, osteoglycine, epiphycan, periostin and osteopontin, TSP-1, asporin. GnHCl HC-HA mainly contained a visible protein band with MW 200 kDa, 80 kDa, and 60 kDa not found in PBS HC-HA (from Coomassie blue stained gel).

Example 31: Constitutive expression of PTX3 by human amniotic stromal cells leads to the formation of HC-HA / PTX3 complex.
In this example, PTX3 expression in HC-HA purified from AM and its effect on the formation of HC-HA / PTX3 complex in AM were examined.

Experimental procedure Materials: Guanidine hydrochloride, cesium chloride, EDTA, anhydrous alcohol, potassium acetate, sodium acetate, sodium chloride, sodium hydroxide, tris base, Triton X-100, 3- (N (N, N-dimethylanilylprimmitylammonio) propane Mixture of sulfonate (Zwittergent ^3-16 ), protease inhibitors (including 4- (2-aminoethyl) -benzenesulfonyl fluoride hydrochloride, aprotinin, bestatin hydrochloride, E-64, leupeptin, and pepstatin A) And phenylmethanesulfonyl fluoride were obtained from Sigma-Aldrich (St. Louis, Mo.) Streptomyces hyaluronidase (HAase) and biotinylated HA binding protein (HABP) were obtained from Seik. from Agaku Biobusiness Corporation (Tokyo, Japan) Dulbecco's modified Eagle's medium, nutrient mixture of Ham's F12, fetal bovine serum, Hanks' solution, gentamicin, amphotericin B and RIPA buffer were added to Invitrogen (Grand Iland , NY) Slide-A-Lyser Dialysis Casesets (3.5K MWCO) was from Fisher Scientific (Pittsburgh, PA) from BCA Protein Assay Kit from Pierd, Rof The HA Quantitative Test Kit was developed by Corgenix ter, CO) 4-15% gradient acrylamide ready gels and nitrocellulose membranes were from Bio-Rad (Hercules, CA). (1,38) prepared from human plasma in our laboratory, PTX3 mAb (MNB4) and pAb were from Enzo Life Sciences, Inc. (Plymouth, PA). TNF, recombinant human Pentraxin 3 / TSG-14 and human / mouse TSG-6 MAb (MAB2104) were from R & D Systems (Minneapolis, Minn.) Mouse anti-human ITIH1 polyclonal antibody against full-length ITIH1 And amino acids Rabbit anti-human ITIH2 polyclonal antibody against 124-321 is available from Abcam Inc. (Cambridge, MA). The isolation kit for HiPerFect Transfection Reagent and RNeasy Mini RNA was from QIAGEN (Valencia, CA). Small interfering RNA (siRNA) oligonucleotides targeting endogenous human PTX3 (ACACUUGAGACUAAUGAAAGAGAGA) and not targeting siRNA control oligonucleotides (scrambled RNA) siRNA are available from OriGene Technologies, Inc (Rockville, MD) It was a thing. Western Lighting ™ Chemiluminescence Reagent is available from PerkinElmer, Inc. (Waltham, MA). The ultracentrifuge (LM8 model, SW41 rotor) is available from Beckman Coulter, Inc. (Fullerton, CA).

2. Cell culture and agarose overlay Human tissues were processed according to Declaration of Helsinki. Fresh human placenta was delivered in a post-partum cesarean section at a Baptist Hospital (Miami, FL) at a Baptist Hospital (Miami, FL) with approval from the Baptist Health South Florida Institutional Review Board (Protocol Number 03-028). Primary human AM epithelial and stromal cells (designated as AMEC and AMSC, respectively) were obtained from fresh placenta as previously described at 37 ° C. in a humidified atmosphere of 5% CO _2. (Chen et al. (2007) Stem Cells. 25: 1995-2005; Li et at. (2008) J. Cell. Physiol. 215: 657-664) and supplemental hormone epithelial medium (DMEM / F12). (1: 1, v / v), 5% (v / v) FBS, 0.5% (v / v) dimethyl sulfoxide, 2 ng / ml EGF, 5 μg / ml insulin, 5 μg / ml transferrin 5 ng / ml sodium selenite, 0.5 μg / ml hydrocortisone, 0.1 nM cholera toxin, 50 μg / ml Tammycin (SHEM) consisting of 1.25 μg / ml amphotericin B (Chen et al. (2007) Stem Cells 25: 1995-2005; Chen et al. (2011) Tissue Eng Part C Methods 17: 537 -548). The medium was changed every 2 days. Cells at 80% confluence were switched to DMEM / F12 containing 0.5% FBS for 48 hours to rest the cells and then 4 hours before exposure to RT-PCR and Western blot analysis. Treated with 20 ng / ml TNF or 20 ng / ml IL-1β for 24 hours or 24 hours. For agarose overlay cultures, AMEC, AMSC and HSF are seeded in 12-well (1 × 10 ⁵ cells / well) and 6-well (2 × 10 ⁵ cells / well) plates at a density of ² × 10 ⁴ / cm ^{2 in} SHEM. The The medium is changed to serum-free SHEM containing 5% KnockOut serum replacement and 1 mM 2-phospho-L-ascorbic acid on day 1 and incubated for another 2 days. After removal of the medium, 3% agarose (low melting type, type VII, Sigma, A9045) in DMEM / F12 with 1 mM 2-phospho-L-ascorbic acid is overlaid with 1 ml or 0.5 ml and 5 ng / A 1 mm thick gel layer was achieved at room temperature for 5-10 minutes before adding 3 ml or 1.5 ml of serum-free SHEM medium for 6 or 12 well plates, with or without ml TNF, respectively. . Cells were harvested on day 5 without media change intervention.

3. siRNA transfection AMEC and AMSC were cultured in SHEM in 6-well plates to 80% confluence. Cells were switched to DMEM / F12 by 0.5% FBS for 48 hours and transfected with PepMute ™ siRNA Transfection Reagent with 100 nM PTX3 siRNA or scrambled (sc) nucleic acid. After 48 hours, cells were harvested and subjected to RT-PCR and Western blot analysis.

4). Purification of HC-HA complexes from AM and serum-free culture by ultracentrifugation HC-HA complexes were purified from AM and cell culture as previously described (He et al. (2009) J. Biol. Biol.Chem.284: 20136-20146; Yoneda et al. (1990) J. Biol.Chem.265: 5247-5257; He et al. (2008) Invest.Ophthalmol.Vis. Sci.49: 4468-4475). . In brief, Bio-tissue, Inc. Cryopreserved human AM obtained from (Miami, FL) was sliced into small pieces, frozen in liquid nitrogen, and ground to a fine powder with a BioPulverizer. The powder was mixed 1: 1 (g / ml) with cold phosphate buffered saline (PBS) buffer. The mixture was maintained at 4 ° C. for 1 hour with gentle agitation and then centrifuged at 48,000 g for 30 minutes at 4 ° C. The supernatant (designated as an AM extract) was then added to an 8M guanidine HCl / PBS solution (v And adjusted to a density of 1.35 g / ml (AM extract) or 1.40 g / ml (cell extract) with cesium chloride, respectively, for 48 hours. , And subjected to isodensity centrifugation at 15 ° C. and 35,000 rpm. The resulting density gradient was fractionated into 12 tubes (1 ml / tube), in which HA and protein contents were measured using the HA Quantitative Test Kit and BCA Protein Assay Kit, respectively. . Fractions from the first ultracentrifugation that contained most of the HA were stored, brought to a density of 1.40 g / ml by addition of CsCl, ultracentrifuged, the same as described above Fractionated by method. Fractions from the second ultracentrifugation that contained HA but no detectable protein were stored and added at a density of 1.42 g / ml by addition of CsCl at the third and The fourth ultracentrifugation was continued. Fractions from the second and fourth ultracentrifugation were dialyzed in distilled water and then 3 volumes of 95 containing 1.3% (w / v) potassium acetate at 0 ° C. for 1 hour. Precipitate twice with% (v / v) ethanol. After centrifugation at 15,000 g, the pellet was briefly air-dried, and stored at -80 ° C., respectively, agents since been briefly be allowed to dry by air, ² nd HC-HA and ^{4 th} of AM Designated as HC-HA.

5. Immunostaining Human fetal membranes containing AM and chorionic section with or without agarose overlay, fixed with 4% paraformaldehyde for 15 minutes at room temperature, Permeabilized with 0.2% (v / v) Triton X-100 in PBS for min. After blocking with 0.2% (w / v) bovine serum albumin in PBS for 1 hour, the sections were biotinylated HABP (5 μg / ml for HA) overnight at 4 ° C. in a humidity chamber. , Anti-PTX3, anti-HC1 or anti-HC2 antibodies (all diluted 1: 200 in blocking solution). After washing with PBS, they were treated with Alexa Fluor 488 Streptavidin (diluted 1: 100 against HA) or the respective secondary antibody (ie, Alexa Fluor 488 anti-mouse IgG, for 1 hour at room temperature). Or Alexa Fluor 555-conjugated anti-rat IgG). A non-specific IgG antibody with an isotype match was used as a control. Alternatively, sections were treated with 50 U / mL Streptomyces HAase for 4 hours at 37 ° C. prior to fixation. Nuclei were stained with Hoechst 33342 and images were obtained using a Zeiss LSM700 confocal laser microscope (Zeiss, Germany).

6). Real-time PCR
Total RNA was extracted from the cell culture using the RNeasy Mini RNA isolation kit. cDNA was reverse transcribed from 1 μg of total RNA with oligo (dT) primer using the Cloned AMW First-Strand cDNA synthesis kit. First strand cDNA was amplified by qPCR using AmpliTaq Gold Fast PCR Master Mix and specific PTX3 primers (46-48). Gene expression of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was used to normalize the amount of amplified product.

7). Western blot The culture supernatant was collected and the cell lysate was washed 6 times with cold PBS, then centrifuged at 14,000 g for 30 minutes at 4 ° C. with gentle agitation and RIPA buffer at 4 ° C. for 1 hour. Obtained by incubating in liquid. The protein concentration in the culture supernatant and cell lysate was quantified with the BCA Protein Assay Kit. Samples are incubated in 50 mM NaOH for 1 hour at 25 ° C. or dissolved in 0.1 M sodium acetate buffer (pH 6.0) and with or without 20 units / ml Streptomyces HAase Without incubation at 60 ° C for 1 hour. They were then resolved by SDS-PAGE on a 4-15% (w / v) gradient acrylamide ready gel under denaturing and reducing conditions and transferred to a nitrocellulose membrane. The membrane was then washed with 5% (w / v) in a buffer of 50 mM Tris-HCl, pH 7.5, containing 150 mM NaCl and 0.05% (v / v) Tween-20. ) With non-fat milk followed by successive incubations with different primary antibodies followed by secondary antibodies of each HRP binding. Immunoreactive protein was visualized by Western Lighting ™ Chemiluminescence Reagent.

Results Positive PTX3 staining in the epithelium and dense stroma of AM.
Fluorescent immunostaining using anti-human PTX3 antibody is performed on a section of fresh human fetal membrane, consisting of epithelial and avascular stroma layers, which includes dense and sponge layers, and underlying cells It is further subdivided into abundant chorion (FIG. 33, phase). Positive PTX3 staining was seen on the epithelium and dense interstitial apical surface. In contrast, PTX3 staining was significantly attenuated in the spongy stroma and chorion (FIG. 33 (PTX3)). HAase digestion did not enhance PTX3 staining in the latter, suggesting that weak PTX3 staining in these two regions was not due to masking effects. Using biotinylated HABP, strong positive HA immunostaining was seen in AM stroma and relatively weak staining was seen in AM epithelium (FIG. 33, HA) while HA was weak Staining was seen in the upper layer of the chorion below the AM stroma, but intense staining was seen in the lower layer of the chorion. This staining disappeared when the tissue section was pre-digested with HAase (FIG. 33, HA (+ HAase)), suggesting that the HA staining was specific. Individual HC immunostaining also revealed positive staining in AM epithelium, stromal cells and matrix, and chorion (FIG. 33, HC1 and HC2). These results suggested the presence of PTX3 in AM predominantly in dense stroma and epithelium.

Presence of PTX3 in AM soluble extract and purified HC-HA complex To further investigate the presence of PTX3 in AM, obtained with isotonic salt buffer before and after treatment with 50 mM NaOH to cleave the ester bond. Western blotting analysis of the resulting AM extract was first performed. Recombinant PTX3 appeared as 45 kDa, 90 kDa, 180 kDa and HMW species (Figure 34, lane 2). The soluble AM extract revealed 45 kDa and HMW species at the bottom of the packed well (mainly not gelled) (Figure 34, lane 3). NaOH treatment did not affect the 45 kDa species, but completely removed the HMW species, resulting in a PTX3 HMW smear (Figure 34, lane 4). These results suggested that PTX3 was present as a monomer and HMW complex in AME. Since the latter can be separated into HMW smears by NaOH, which can cleave the ester covalent bond between HC-HA, the species containing HMW PTX3 in the filled well may bind to HC-HA. unknown.

To further confirm whether PTX3 bound to the AM HC-HA complex, as previously reported, the HC- The HA complex was purified (He et al. (2009) J. Biol. Chem. 284: 20136-20146 .; Zhang et al. (2012) J. Biol. Chem. 287: 12433-12444) and subjected to HAase digestion. Western blotting analysis was performed with or without. In contrast to monomer was observed in soluble AME, species 90kDa corresponding to the size of natural PTX3 dimer, at the bottom of the filling wells, the 2nd and ^{4 th} of AM other than HMW bands HC -Indicated by HA complex (Figure 34, lanes 5 and 7). Furthermore, HMW smears were also found to be weak in 2 ^nd HC-HA and strong in 4 ^th HC-HA complex. After HAase treatment, the 90 kDa dimer remained in both HC-HA complexes, but HMW smear was enhanced in 4 ^th HC-HA, increased in 2 ^nd HC-HA, and the HMW band at the top of the gel. The disappearance of (Figure 34, lanes 6 and 8) was similar to the results seen with AME. The presence of the 90 kDa PTX3 dimer in the HC-HA complex with or without HAase is caused by 2-ME as a removal of 2-ME resulting in the lack of this 90 kDa species (not shown). It was found to be caused by separation from HC-HA. These results indicated that the HC-HA complex contained PTX3 bound to HC-HA to form the HC-HA / PTX3 complex despite four ultracentrifugations. Suggested.

Western blot analysis with anti-HC1 antibody revealed the presence of HC-HA complex as a species of HMW at the bottom of packed wells that disappeared after HAase digestion (FIG. 34, lanes 10-13), and HC- after HAase digestion. The presence of HC1 in the HC-HA complex released from the HA complex (FIG. 34, lanes 11 and 13) was shown. HC2 and TSG-6 (not shown) were not detected. These results collectively confirmed that the HC-HA purified from AM only contained HC1. ^Further, 2 nd HC-HA key difference between the complex and the ⁴ th HC-HA complex is observed, i.e., HC1 band of free 80kDa was ^detected only in the 2 nd HC-HA complex, Not detected in the 4th HC-HA complex (FIG. 34, lane 11), suggesting that the latter did not contain free HC1. The presence of HA in 4th HC-HA was confirmed by agarose gel electrophoresis displaying as a continuous HA smear from the top packed well to the bottom of the gel, and such smearing was resolved by HAase digestion. .

Expression of PTX3 mRNA and protein by AMEC and AMSC It was subsequently determined that PTX3 was synthesized by AM epithelial and stromal cell cultures. These cells were cultured as reported (Chen et al. (2007) Stem Cells 25 (8): 1995-2005; Li et al. (2008) J Cell Physiol. 215 (3): 657-64. Zhang et al. (2012) J. Biol. Chem. 287: 12433-12444), extracting total RNA for RT-PCR and protein for Western blot analysis and extracting them into human skin fibroblasts ( Compared with HCF), it was reported to express PTX3 mRNA and protein only under stimulation of pro-inflammatory cytokines such as TNF and IL-1. As expected, qRT-PCR results showed that the expression rate of PTX3 transcripts was low in resting HSF but was up-regulated by TNF and IL-1β (A in FIG. 35). Expression of PTX3 transcripts in resting AMECs and AMSCs was low, but was dramatically enhanced by TNF or IL-1β (FIG. 35A). Western blot analysis showed that PTX3 protein was low in lysate (45 kDa) and undetectable in medium in resting HSF (FIG. 35B, lane 2) but 24 hours after addition of TNF or IL-1β. , It was confirmed that it was detected in the lysate, not in the medium. In contrast, PTX3 protein is detectable in resting AMEC and is significantly increased by TNF or IL-1b in both lysate (45 kDa) and medium (45 kDa and 90 kDa) (FIG. 35B, lane 5). , 6 and 7), TNF was more effective than IL-1b. The same results were shown with AMSC (FIG. 34B, lanes 8, 9 and 10). The 75 kDa and 135 kDa bands in the lysates from all cells and the 50 kDa band in the medium were non-specific because these bands were not altered under TNF or IL-1b PTX3 siRNA transfection was performed to actually down-regulate both 45 kDa species and both 45 kDa and 90 kDa species in the lysate, but not in these non-specific bands ( FIG. 35C). These results collectively suggested that PTX3 was actually synthesized and secreted by resting AM cells and was further upregulated by proinflammatory stimuli.

Generation of HC-HA / PTX3 complex by AM stromal cells Previous studies have shown that mouse dermal fibroblasts cultured in medium supplemented with HC-HA (ie, SHAP-HA) complex supplemented with FBS. It was possible to isolate from the cell layer of cells and showed that the isolated HC-HA contains both HC1 and HC2 of IαI derived from FBS (Yoneda et al. (1990) J. Biol. Biol.Chem.265: 5247-5257; Huang et al. (1993) J. Biol.Chem.268: 26725-26730). However, we reported that AM cells produce HC-HA by using its endogenously generated IαI (Zhang et al. (2012) J. Biol. Chem. 287: 12433-12444). ). Since AM cells synthesized PTX3 protein that was further increased by TNF and IL-1, we aimed to determine if they produced HC-HA that also contained PTX3. HSF as a control, which expressed PTX3 only under pro-inflammatory stimuli such as TNF and IL-1 under the conditions of serum addition, was used (Yoneda et al. (1990) J. Biol. Chem. 265). Hang et al. (1993) J. Biol. Chem. 268: 26725-26730) (FIG. 35), cultured under both serum-free and serum-added conditions, with or without TNF. AMEC and AMSC were compared. Also, 3% agarose is layered on the cell monolayer because, by this method, secreted procollagen is captured at or near the cell surface, rather than in the medium on the culture of keratocytes. (Hassell et al. (2008) Experimental Eye Research. 87: 604-611; Etherege et al. (2010) Matrix Boil. 29: 519-524).
After 5 days overlay, HSF, AMSC and AMEC became more compact, especially under conditions of serum addition (FIG. 36). Epithelial morphology was more different in AMEC.

  Subsequently, it was determined whether the 3% agarose overlay was also effective in capturing secreted HA by measuring HA concentration in the culture medium by HA ELISA assay. Without agarose overlay, HA levels were readily detectable in both AMSC and AMEC serum-free media, but not in HSF. TNF significantly increased HA levels in all three cell cultures (FIG. 37). The above pattern was further promoted in serum supplemented medium. The agarose overlay reduced HA levels greater than 50% in both three cultures under both serum-free and serum-added conditions. These results suggested that the agarose overlay actually reduced HA levels to the culture medium.

Specific antibodies against HC1 and HC2 and two different anti-PTX3 antibodies, MNB4 and biotin label, to determine when the secreted HA was actually captured in the extracellular matrix after agarose overlay Double immunostaining was performed for the conjugated pAbs, PTX3 / HA, HC1 / HA, and HC1 / PTX3 with biotinylated HABP, respectively. In serum-free conditions, positive HA staining was shown in the pericellular region in HSF, while PTX3 staining was negative (A in FIG. 38). Upon TNF stimulation, positive PTX3 staining was observed in the cytoplasm (FIG. 38B), confirming inducible expression of PTX3 by TNF in HSF. TNF did not significantly increase the intensity of HA staining, but induced a cable-like structure (G in FIG. 38) similar to that reported in cultured renal proximal tubular epithelial cells (FIG. 38G). Selbi et al. (2006) Kidney International. 70: 1287-1295). No co-localization of PTX3 with HA was observed, suggesting that PTX3 did not bind to HA in HSF after TNF stimulation.
In contrast, positive HA staining was detected in AMSCs resting as a fibrous network on the cell surface and extracellular matrix because it was colocalized with HA in the extracellular matrix (FIGS. 38C and 6K). TNF increased the intensity of PTX3 staining and the amount of HA fibrils (D and K in FIG. 38).

  In resting AMEC, positive HA staining was also found in the extracellular space with some fibrillar appearance, but it was only found in scattered areas where the cells were not dense (FIG. 38). E and L). Co-localization of PTX3 and HA was also observed in AMEC. TNF treatment further increased the intensity of PTX3 staining and the amount of HA fibrils (FIG. 38F). These results further confirmed that PTX3 was constitutively expressed by AMSC and AMEC and that its expression was further increased by TNF. Weak positive HC1 staining was observed only with some HSF, with or without TNF treatment (G and J in FIG. 38) (not shown), especially the cable-like structure of HA (FIG. Co-localized with HA in 38 G). However, we did not mention the colocalization between HC1 and PTX3 (J in FIG. 38). In contrast, strong positive HC1 staining was shown in AMSC, colocalized with HA on the cell membrane (FIG. 38H), and colocalized with PTX3 in the cytoplasm (FIG. 38K). . AMEC also showed strong positive HC1 staining and co-localization with HA in the cell membrane (I in FIG. 38) and PTX3 in the cytoplasm and cell membrane (L in FIG. 38). Taken together, these results show that the HA-rich matrix is effectively captured by the agarose overlay in AMSC, AMEC and HSF and contains both HC1 and PTX3 only in AMSC and AMEC under serum-free conditions. This further confirms that such HC-HA / PTX3 complexes were synthesized by endogenous IαI.

To further confirm the formation of the HC-HA / PTX3 complex under the agarose overlay, the cell layer was extracted with 6M GnHCl and with or without NaOH treatment under both serum-free and serum-added conditions. Western blot analysis was performed on AMSC and HSF cultures. Serum-free HSF showed 170 kDa and 140 kDa species with or without TNF stimulation and NaOH treatment, but no 45 kDa species corresponding to control PTX3, indicating that these two bands are specific. This suggests that there was not (D in FIG. 38, lanes 2-5). Serum-added HSF with TNF showed a weak 140 kDa species and several small MW species similar to those seen with serum-free HSF (Figure 39, lanes 11 and 12). In contrast, serum-free AMSCs showed weak HMW PTX3 smears, 90 kDa and 45 kDa species (Figure 39, lane 6), the latter two corresponding to PTX3 dimer and monomer, respectively ( FIG. 39, lane 2). These results were similar to those seen with AME (FIG. 34). The same non-specific 170 kDa species and several small molecular species that were found in serum-free HSF were also observed. NaOH treatment increased HMW PTX3 smear but did not affect PTX3 monomer and dimer (FIG. 39, lane 7) and other species. TNF also increased HMW PTX3 smears, PTX3 dimers and monomers as in other species (Figure 39, lanes 8 and 9). Serum supplemented AMSC with TNF showed a potent HMW PTX3 smear, 90 kDa PTX3 dimer and 45 kDa PTX3 monomer (Figure 39, lane 13).
NaOH treatment significantly increased HMW PTX3 smear and two species at 60 kDa and 50 kDa (FIG. 39, lane 14). These results suggested that HMW PTX3 was released from the HC-HA complex because NaOH broke the ester bond between HC and HA, leading to HC-HA dissolution. In summary, the above results suggested that AMSC but not HSF produced an HC-HA complex containing PTX3.

In vitro reconstitution of the HC-HA / PTX3 complex (rcHC-ha / PTX3) To further confirm how the HC-HA / PTX3 complex can be generated, we have identified HA, TSG-6, I would like to reconstitute the HC-HA / PTX3 complex in vitro using IαI and PTX3. First, HA was immobilized on plastic, recombinant TSG-6 was successfully added, and IαI or serum was purified as a source of IαI. TSG-6 can bind to HA immobilized on a solid surface to form a stable TSG-6 / HA complex (Wisniewski et al. (2005) J Biol Chem. 280: 14476). -84), both free and HA-bound TSG-6 can move HC from IαI to immobilized HA to form HC-HA (Colon (2009) J Biol Chem. 284: 2320-31). Western blot using anti-IαI antibody did not detect species in the control iHA alone as expected (A in FIG. 40, lane 2). When IαI and TSG-6 were added simultaneously to iHA, weak 220 kDa IαI, 85 kDa HC2, strong ˜80 kDa HC1 and 50 kDa species were detected (FIG. 40A, lane 3), Both HC1 and HC2 were transferred to iHA in the presence of TSG-6, suggesting that HC-HA was formed. Comparison of HC1 band intensity to HC2 band intensity suggested that more HC1 was transferred to iHA than HC2 by TSG-6, resulting in a tapered 50 kDa species. When PTX3 was concomitant with IαI and TSG-6 to iHA, the intensity of IαI species decreased, while HC1 intensity increased in a dose-dependent manner of PTX3 (FIG. 40A, lanes). 4-6) On the other hand, HC2 was undetectable, suggesting that PTX3 preferentially promoted the transfer of HC1 but not HC2 to immobilized HA catalyzed by TSG-6. ing. When PTX3 is added after the simultaneous addition of IαI and TSG-6, HC1 is detected rather than IαI or HC2, and HC1 intensity is also increased in a dose-dependent manner for PTX3 (FIG. 40A, lanes). 7-9), which confirms that PTX3 promoted the transfer of HC1, but not HC2, to the immobilized HA. These results suggested that PTX3 uniquely promoted preferential HC1 migration to immobilized HA, forming a HC1-HA complex, whether simultaneous or continuous. Western blots using anti-TSG-6 antibodies were formed by the simultaneous or sequential addition of both 35 kDa TSG-6 monomer and 75 kDa dimer with IαI on iHA and central PTX3 of TSG-6 It was shown that it was detected in rcHC-HA. The intensity of the TSG-6 band decreased in a PTX3 dose-dependent manner, suggesting that TSG-6 bound to immobilized HA could be competed out by PTX3 (FIG. 40B). Western blots using anti-PTX3 antibody showed prominent HMW PTX3 smears in packed wells with weak tetramer and dimer bands when PTX3 was added with IαI and TSG-6 simultaneously. Intensity was shown to increase in a dose-dependent manner with PTX3 (FIG. 40C and lanes 4-6). This result suggested that PTX3 was preferentially and strongly bound to the rcHC-HA complex, in which the binding was resistant to 8M GnHCl wash. In contrast, when PTX3 was added sequentially after the addition of IαI and TSG-6, HMW PTX3 and tetrameric and dimeric species (FIG. 40C, lanes 7-9) were detected. This suggests that the binding between PTX3 and the preformed rcHC-HA PTX3 was not strongly resistant to 8M GnHCl wash. Thus, these in vitro reconstitution experiments suggest that PTX3 had to be generated simultaneously with HA, IαI and TSG-6 in vivo to allow the formation of HC-HA / PTX3. did. This interpretation was supported by immune co-localization of HA, HC and PTX3 in the extracellular matrix formed by AMSC in addition to in vivo tissue sections.

Example 33: Effect of HC-HA complex on TGFβ1 signaling Immobilized HC-HA inhibits TGFβ1 signaling by down-regulating TGF-β1 expression but increases TGF-β3 signaling Regulate. Such inhibition of TGFβ1 signaling can resist challenge by addition of serum or exogenous TGF-β1 due to further suppression of GFβRII and TGFβRIII. Thus, immobilized HC-HA prevents myofibroblast differentiation of corneal fibroblasts by inhibiting the expression of SMAD2 / 3 signaling alpha smooth muscle formation. This action is also powerful enough to return corneal fibroblasts to keratocytes. HC-HA (insoluble (I)), unlike HC-HA (soluble (S)) in the construction of additional small leucine-rich protein (SLRP), up-regulates the expression of BMPs and their receptors By activating pSMAD1 / 5/8, which activates the expression of TGFβ1 and BMP signaling and therefore further promotes the formation of aggregates together. These effects can further dedifferentiate corneal fibroblasts into neural crest progenitors.

  In this example, the effect of immobilized soluble and insoluble HC-HA on TGF-β signaling in human corneal fibroblasts with or without exogenous TGFβ1 challenge was examined. Furthermore, the effect of the HC-HA complex on SMAD2 / 3 signaling and inhibition of αSMA expression was tested.

  Experimental and clinical studies support the therapeutic effect of anti-scarring by cryopreserved amniotic membrane (AM). Our study demonstrates that the heavy chain hyaluronan complex (HC-HA) can be uniquely generated and purified from AM and represses the activity of the TGF-β1 promoter in human corneal fibroblasts did. It is unclear whether HC-HA promotes TGF-β3 mRNA and protein expression, which is known to suppress TGF-β1 mRNA and protein expression and neutralize TGF-β signaling. Even so, it is also unclear whether such inhibition of TGFβ signaling by HC-HA translates to suppression of pSMAD2 / 3 nuclear translocation.

  Mouse keratocytes can maintain an undifferentiated state (expressing keratocan) in serum-free DMEM / ITS or DMEM / 10% FBS on plastic when cultured on AM. Treatment of corneal parenchymal cells in serum-free DMEM / ITS with 10% serum or 10 ng / ml TGF-β1, Smad2 / 3 phosphorylation and nuclear localization (3 hours) and α-SMA expression (5 days) To trigger. Activation of Smad2 / 3 and α-SMA in corneal parenchymal cells against AM by treatment with either serum or TGF-β1 is suppressed (Kawakita et al. (2005) J Biol Chem. 280 (29): 27085-92 ). Our study demonstrated that HC-HA represses the activity of the TGF-β1 promoter in human corneal fibroblasts. pSmad2 / 3 signaling and α-SMA formation were expected to be suppressed by HC-HA.

  Human corneal fibroblasts (or limbal niche cells, p3) were immobilized on HA, soluble HC-HA (PBS) (2X) for 48 hours as described above. Or 4X) or insoluble HC-HA (GnHCl) (2X or 4X) or without seeding on plastic dishes. Cells were then treated with or without TGFβ1 for 24 hours before harvesting for mRNA quantification and determination of SMAD2 / 3 signaling. For TGFβ receptor protein determination, cells were treated with or without TGF-β1 for 48 hours prior to collection of protein samples to give time for protein expression from the expressed mRNA. For the TGF-β1 ELISA, cells were treated with or without TGF-β1 for 24 hours and then cultured in fresh media for 24 hours (and 48 hours). The supernatant was collected for TGF-β1 ELISA. For TGF-β2 and TGF-β3 ELISA, cells were treated with or without TGF-β1 for 48 hours. Supernatants were collected for TGF-β2 and TGF-β3 ELISA. Phase contrast images were taken for up to 72 hours for various cultures.

  The following experiments were performed:

  1. MRNA semi-quantification for TGF-β1, TGF-β2, TGF-β3, and their receptors by real-time PCR was used to estimate the expression of TGF-β family and mRNA transcripts of those receptors . The real-time RT-PCR profile consisted of initial activation at 95 ° C. for 10 minutes, followed by 40 cycles of 15 seconds denaturation at 95 ° C., and 1 minute annealing and extension at 60 ° C.

  2. Determination of α-smooth muscle formation and SMAD2 / 3 signaling by immunostaining: was performed to monitor α-smooth muscle formation and SMAD2 / 3 signaling using standard immunostaining procedures.

  The experimental groups for Experiments 1 and 2 were as follows:

  3. Quantification of TGFβRs by Western blotting: Using its corresponding antibody, it was used to quantify protein concentrations of TGFβRI, TGFβRII, and TGFβRIII (R & D Systems). The packing sequence was as follows:

  4). ELISA for quantification of TGFβs in medium: Quantikine Human TGF-β1 and TGF-β2 ELISA Kits from R & D Systems and TGF-β3 ELISA Kits from Norbus Biologicals, acid-activated cell culture supernatant, Solid phase ELISA designed to measure TGF-β1, TGF-β2 and TGF-β13 in plasma and urine. They contain recombinant human TGF-β1, TGF-β2 and TGF-β3 and have been shown to accurately quantify recombinant factors. The results obtained using native TGF-β1, TGF-β2, TGF-β3 showed a linear curve parallel to the standard curve obtained using the recombinant kit criteria. These kits were used to determine TGF-β1, TGF-β2 and TGF-β3 in the medium. The experimental groups for Experiment 4 were as follows:

Results HCF seeded in DMEM / 10% FBS formed aggregates every 72 hours only on insoluble HC-HA (FIG. 41). Such aggregation persisted after 24 hours of serum starvation in DMEM / ITS (insulin / transferrin / selenium) medium. The cells were then cultured into three different culture media: A-48 hours DMEM / IT; B-24 hours DMEM / IT, 24 hours DMEM / 10% FBS; C-24 hours DMEM / IT. 24 hours DMEM / ITS with ITS, 10 ng / ml TGF-β1. Cells cultured in HC-HA formed small aggregates on 4X HC-HA (Gn), but were different in other culture conditions (FIG. 41). However, only HCF in the control adhered well after 2 hours inoculation in DMEM / 10% FBS on immobilized substrate. The cells on HA, HC-HA [HC-HA (4X, PBS) and 4X, GnHCl] are all curled, indicating that they were not well attached. After 72 hours of incubation, all cells attached well, but there were few cells on immobilized HC-HA. The number of cells on these substrates was higher on HC-HA (4X, PBS) than on HC-HA (4X, GnHCl). HCF began to form aggregates on HC-HA (Gn) after 24 hours of culture and was condensed into larger aggregates after 72 hours of culture. After stimulation with TGFβ1, aggregation of HCF cultured on HC-HA (4X, PBS; 4X, Gn) was observed.

  In summary, HC-HA (Gn) promotes HCF aggregation with or without TGFβ1 challenge, while HC-HA (PBS) promotes HCF aggregation under TGFβ1 challenge. . The significance of aggregation is not known.

  In DMEM / ITS, TGFβ1 and TGFβ3 transcript expression was enhanced by HC-HA (Gn), whereas TGFβ3 transcript was enhanced by HC-HA (PBS) (FIG. 42). As expected, in self-induction, TGFβ1 and TGFβ3 mRNA were increased 4-fold and 2-fold, respectively, in HCF cultured on plastic by TGFβ1 challenge, correspondingly, TGFβ1 protein was between 60 pg / ml and 105 pg. (TGFβ3 protein was not detected in the experiment due to experimental error). Under serum-free conditions, soluble 4X HC-HA decreased the expression of TGFβ1 protein. Insoluble HC-HA also decreased secreted TGFβ1 despite its enhancement of TGFβ1 mRNA expression, but was still higher than controls cultured in DMEM / ITS. Furthermore, significant suppression of TGFβRII and TGFβRIII by both soluble and insoluble HC-HA was observed. As a result, autocrine TGFβ signaling was suppressed in HCF cultured on either soluble or insoluble HC-HA, whereas paracrine TGFβ signaling was stored in HCF cultured on insoluble HC-HA. Is done. Furthermore, both soluble and insoluble 4X HC-HA upregulated TGFβ3 mRNA expression under serum-free conditions, with or without TGFβ1 stimulation, known to neutralize TGF-β1 signaling. . Under stimulation with TGFβ1, TGFβ3 mRNA expression was increased 5-fold and 8-fold, respectively, when HCF was cultured on soluble and insoluble HC-HA, which resulted in soluble and insoluble HC-HA. , Which strongly promotes the expression of TGFβ3 transcripts. These results also indicate that HC-HA purified from AM promotes the anti-scarring effect of AM not only by suppressing TGFβ1 signaling, but also by significant upregulation of TGFβ3 expression. Our results indicate that HC-HA (PBS and Gn) does not affect TGFβ2 expression at both mRNA and protein levels. In summary, HC-HA (PBS) inhibits TGFβ1, but activates TGFβ3 signaling in HCF challenged by TGFβ1, whereas HC-HA (Gn) stimulates both TGFβ1 and TGFβ3 signaling. Activate.

  In the plastic control, TGFβRII mRNA was up-regulated 8-fold under TGFβ challenge (FIG. 43). TGFβII and TGFβIII receptor mRNA were up-regulated by HC-HA (PBS and Gn), respectively, under serum-free conditions, but were completely inhibited under TGFβ1 challenge. The same result can be said for HA. Corresponding protein expression of TGFβRII and TGFβRIII is 3 and 3 times, and 2 and 3 times, respectively, when HCF cultured on HC-HA (PBS and Gn, respectively) is challenged with TGFβ. Down regulated. Under this circumstance, the expression of these proteins was not altered by HA. Such down-regulation can be a partial explanation for anti-inflammatory mechanisms and the effects of anti-scarring by AM. In summary, TGFβR2 and TGFβR3 mRNA expression increased when HCF was cultured on HA and HC-HA (PBS and Gn).

  Immunostaining showed that HC-HA (PBS and Gn) inhibited nuclear translocation of pSMAD2 / 3 in both DMEM / ITS with or without TGFβ1 challenge (FIG. 44). Such an effect was more apparent with TGFβ. This result further confirmed that suppression of TGFβ1, TGFβRII and TGFβRIII was converted to suppression of SMAD-mediated signaling.

  Furthermore, immunostaining results showed that both soluble and insoluble HC-HA inhibited α-SMA formation after TGFβ1 challenge, indicating that it was inhibited, which was soluble and insoluble. Such inhibition of β1 signaling by HC-HA further supports inhibiting HCF differentiation into myofibroblasts with or without the addition of TGFβ1 (FIG. 45).

  In summary, soluble HC-HA down-regulates TGF-β1, but upregulates TGF-β3 expression, while insoluble HC-HA, under conditions of serum-free and TGFβ1 challenge, Upregulates the expression of both TGF-β1 and TGF-β3 in HCF. Because both soluble and insoluble HC-HA down-regulated the expression of both TGFβRII and TGFβRIII, these changes are evidenced by the absence of pSMAD2 / 3 nuclear translocation and suppression of alpha smooth muscle formation. As such, it resulted in inhibition of TGFβ signaling.

Example 34: Effect of HC-HA complex on BMP signaling In this example, the effect of HC-HA immobilized by additional TGF-β1 on BMP signaling was examined. The activation of BMP signaling via activation of pSMAD1 / 5/8 was also determined.

  BMP constitutes a subgroup of the TGFβ superfamily, including BMP1-3, BMP3b, BMP4-7, BMP8a, BMP8b, BMP9-15. BMP binds type II receptors (ALK2, ALK3, or ALK6), which activate type I receptors and phosphorylate Smad1, Smad5, and Smad8, resulting in pSmad1 / 5 / Resulted in 8 nuclear translocations (reviewed in Massague 2000; Herpin, 2007). It is not clear which specific BMPs and BMP receptors are present in HCF, and even if known, BMP signaling is HC-HA (PBS and Gn) when TGFβ signaling is suppressed. It is not clear whether it is activated by TGFβ1 and further, even if known, which forms of BMP and BMP receptors play a major role in controlling BMP signaling and that of BMP signaling It is unclear whether such activation is due to pSMAD1 / 5/8.

  Human corneal fibroblasts are seeded on plastic for 48 hours with or without immobilized HA or HC-HA PBS (4X) or HC-HA Gn (4X) and then described above. As such, pSMAD1 / 5/8 mRNA was treated with or without TGFβ1 for quantification and determination for 24 hours. For the determination of BMP receptor protein, cells were treated with or without TGF-β1 for 48 hours prior to collection of protein samples to allow protein expression. For BMP ELISA, cells were treated with or without TGF-β1 for 48 hours. The supernatant was collected for BMP ELISA. Phase contrast images were taken for up to 72 hours for various cultures.

  The following experiments were performed on the culture:

  1. MRNA semi-quantification for BMP and its receptors by real-time PCR was used to estimate the expression of mRNA transcripts of the BMP family and their receptors.

  2. Determination of α-smooth muscle formation and SMAD1 / 5/8 signaling by immunostaining was performed to monitor α-smooth muscle formation and SMAD2 / 3 signaling by immunostaining.

  The experimental groups for Experiments 1 and 2 were as follows:

  3. Quantification of BMPR by Western blotting using BMPR1A, BMPR1B and BMPR2 antibodies: was used to quantify the protein concentrations of BMPR1A, BMPR1B and BMPR2, respectively. The packing sequence was as follows:

  4). ELISA for quantification of BMP in medium: A BMP ELISA kit (R & D Systems) was used to determine BMP in the medium. The experimental groups for Experiment 4 are as follows:

Results Under resting conditions, both HA and HC-HA (PBS) and HC-HA (Gn) activate BMP6 transcript expression 7-fold and 4-fold, respectively (FIG. 46). In the presence of TGFβ1, both HA and HC-HA (PBS) and HC-HA (Gn) have 6-fold, 11-fold and 6-fold BMP6 transcript expression in HCF, and BMP6 mRNA, respectively. Expression is activated 30-fold, 37-fold and 46-fold, which means that HA and both soluble and insoluble HC-HA can upregulate BMP4 / 6 expression, while additional TGFβ1 It shows that BMP6 signaling was more dramatically upregulated. BMP7 and BMP9 were not detected.

  TGFβ1 itself did not activate the expression of BMPR1A transcripts, but not HA, both HC-HA (PBS) and HC-HA (Gn), expressed BMPR1A transcripts in the presence of TGFβ1. Are activated 7-fold and 3-fold, respectively, indicating that BMPR1A may play a major role in BMP signaling of HC-HA + TGFβ1 activation (FIG. 47). Furthermore, TGFβ1 activates BMPR1B three-fold and BMPR2 three-fold, but four-fold activation on plastics with and without both HA and HC-HA (PBS) and HC-HA (Gn). This indicates that TGFβ1 itself non-specifically activates BMPR1B and BMPR2 mRNA expression. HC-HA (PBS) or HC-HA (Gn) enhances the expression of BMPR2 transcripts up to 4-fold. BMP-BMPR1A is expected to activate SMAD1 / 5/8 signaling, while BMP-BMPRII is expected to activate non-SMAD signaling.

  The immunofluorescence results show that TGFβ1 itself moderately activates the nuclear translocation of pSMAD1 / 5/8 in HCF, regardless of the substrate used (FIG. 48). As evidenced by more nuclei with pSMAD1 / 5/8 and the much stronger nuclear staining of pSMAD1 / 5/8, HC-HA (PBS and Gn) is responsible for nuclear translocation of pSMAD1 / 5/8. It strongly promotes the activation of BMP4 / 6 signaling.

  ID1 is a known downstream gene regulated by SMAD1 / 5/8 signaling, a helix loop helix (HLH) capable of forming heterodimers by members of the basic HLH family of transcription factors. ) Protein. Our results show that when HCF is cultured on HC-HA (PBS) and HC-HA (Gn), the activation of SMAD1 / 5/8 is 4 and 8 times higher than ID1 mRNA, respectively. Demonstrating that it resulted in regulation, this indicates that SMAD1 / 5/8 signaling in HCF is actually activated by HC-HA + TGFβ (FIG. 49). Since ID1 has no DNA binding activity and therefore can inhibit the ability of interacting basic HLH proteins to bind to DNA and activate transcription, we have identified that ID1 is responsible for cell growth, aging and Expect to play an important role in differentiation.

Example 35: Effect of HC-HA complex on myofibroblast differentiation and conversion of corneal fibroblasts into keratocytes or younger precursors of neural crest-derived cells embedded in corneal matrix Corneal parenchymal cells, a unique aggregate, express proteoglycans containing keratan sulfate, including keratocan specific for the cornea. Keratocan (Kera) is a keratan sulfate proteoglycan (KSPG) specific for the cornea in the eyes of adult vertebrates. It belongs to the gene family of small leucine-rich proteoglycan (SLRP) and is one of the main components of extracellular KSPG in vertebrate corneal matrix. Corneal KSPG plays a central role in matrix assembly, which is a factor in corneal transparency. Lumican constitutes approximately half of the corneal KSPG. Most of the remaining corneal keratan sulfate denatures keratocan. In adult tissues, keratocan is confined to the corneal matrix and keratocan expression is considered a phenotypic marker for corneal parenchymal cells (Liu et al. (2003) J. Biol Chem. 278 (24): 21672). 7; Carlson et al. (2005) J Biol Chem. 280 (27): 25541-7). On plastic dishes, human, bovine, and rabbit corneal parenchymal cells lose their characteristic dendritic morphology and keratocan expression when cultured in serum-supplemented media (Espana et al. (2003) Invest). 44 (12): 5136-41; Espana et al. (2004) Invest Ophthalmol Vis Sci. 45 (9): 2985-91). These exposed cells down-regulate the expression of proteoglycans containing keratan sulfate, keratocan and CD34, and up-regulate the expression of proteoglycans and α-SMA containing chondroitin dermatan sulfate, which , Indicating that these cells become more differentiated.

  Previous work has been described in humans (Espana et al. (2003) Invest Ophthalmol Vis Sci. 44 (12): 5136-41; Espana et al. (2004) Invest Ophthalmol Vis Sci. 45 (9): 2985-91). Even when the corneal parenchymal cells of the mouse (Kawakita et al. (2005) J Biol Chem. 280 (29): 27085-92) are added to the serum-supplemented medium by down-regulation of the Smad signaling pathway. When cultured on the stromal surface of AM, it has been shown that their phenotype can be maintained without differentiation of α-SMA expressing myofibroblasts. The amniotic stroma maintains keratocan expression in culture and can prevent keratocytes from differentiating into myofibroblasts (Kawakita et al. (2005) J Biol Chem. 280 (29). : 27085-92). Corneal parenchymal cells maintain a dendritic morphology and continue to express keratocan specific for the corneal substrate for at least 5 passages (in a 1: 2 split) under serum addition conditions or addition of TGF-β1 And α-SMA was not expressed (Espana et al. (2004) Invest Ophthalmol Vis Sci. 45 (9): 2985-91). Murine keratocytes can also be expanded on AM for at least 8 passages without losing their normal phenotype, and its suppression of the Smad-mediated TGF-β signaling pathway expresses keratocan (Kawakita et al. (2005) J Biol Chem. 280 (29): 27085-92). In this example, it was examined whether the immobilized HC-HA could do the same, and if so, whether additional TGFβ1 would affect the result.

Results HA up-regulated keratocan mRNA expression 4 fold (FIG. 50). Human corneal fibroblasts are seeded on plastic for 48 hours with or without immobilized HA, starved for 24 hours without serum, and then for mRNA quantification and determination of SMAD2 / 3 signaling Treated with or without TGFβ1 for 24 hours before harvesting. With respect to the determination of TGFβ receptor protein, cells were treated with or without TGF-β1 for 48 hours prior to collection of protein samples because protein expression was delayed with respect to mRNA expression. For the TGF-β1 ELISA, cells were treated with or without TGF-β1 for 24 hours and then cultured in fresh medium for 24 hours (and 48 hours). The supernatant was collected for TGF-β1 ELISA. For TGF-β2 and TGF-β3 ELISA, cells were treated with or without TGF-β1 for 48 hours. Supernatants were collected for TGF-β2 and TGF-β3 ELISA. As expected, immobilized HC-HA promoted keratocan mRNA expression 14-fold and 16-fold, indicating that these HCFs are much younger when cultured on HC-HA without TGFβ1. Is shown. Following TGFβ1 challenge, keratocan mRNA expression was dramatically down-regulated on plastic and HA. However, keratocan expression was still maintained 3 fold on HC-HA (soluble, PBS). Keratocan expression was absent on HC-HA (insoluble, Gn). We expect that the resulting phenotype on HC-HA (I) should be even younger than corneal parenchymal cells.

  Similarly, immobilized HC-HA (I / S) promoted keratocan protein levels 8-fold and 10-fold, as these HCF were cultured on HC-HA (S / I). Sometimes, it is actually returned to corneal parenchymal cells (FIG. 51). No expression of the corresponding keratocan protein was seen with other treatments tested, including HA (4 fold increase in keratocan mRNA) and 4X HC-HA (PBS) (3 fold increase in keratocan mRNA); This indicates that such moderate increase in keratocan mRNA was not sufficient to promote expression of the corresponding protein of keratocan.

Example 36: Effect of HC-HA complex on ESC marker expression in HCF Example 35 only prevents HCF from undergoing myofibroblast differentiation under exogenous TGF-β1 challenge Rather, it showed strong evidence that expression of keratocan was returned to keratocytes by or without exogenous TGF-β1. Therefore, test whether HCF can be further reprogrammed to younger precursors, especially when seeded with exogenous TGF-β1 on immobilized HC-HA (insoluble, GnHCl), This was shown to suppress TGF-β signaling and promote BMP signaling but stop keratocan expression. As we recently reported to be found in angiogenic precursors, we examined the expression of many markers found in ESC and endothelial precursors and pericytes. To further investigate the possibility of HCF reprogramming under these conditions regulated by HC-HA, it was reported to play an important role in reprogramming adult differentiated fibroblasts into iPSCs The expression of four important transcription factors, namely Sox2, Oct4, c-Myc, and KLF4, was examined.

Results Examination of gene expression was performed on the HCF culture described above in Example 35. The results show that cMYC, KLF-4 on 4X HC-HA, even when HCF was challenged with exogenous TGF-β1 compared to plastic controls (p <0.05, n = 3). It was shown that more (2-6 fold) ESC markers, such as Nanog, Nestin, Oct4, Rex-1, SOX-2, and SSEA-4, and 2-4 fold more ESC markers were expressed ( FIG. 52). These results suggest that HC-HA, particularly HC-HA (insoluble), can reprogram HCF to younger precursors.

Example 37: HC-HA in solution inhibits bone formation by affecting the viability and differentiation of MC3T3-E1 cells.
In this example, the effects of HC-HA (soluble fraction) and HA in solution on the viability and differentiation of undifferentiated MC3T3-E1 cells were evaluated. MC3T3-E1 is an osteoblast cell line established from C57BL / 6 mice. MC3T3-E1 cells have the ability to differentiate into osteoblasts and bone cells and have been demonstrated to form bone tissue that is mineralized in vitro.

MC3T3-E1 cells are cultured in complete medium (α-, at various concentrations of HA (1, 5, 25, 100 μg / ml) or HC-HA (1, 5, and 25 μg / ml) with PBS as a vehicle control. MEM, 10% FBS, 100 units / ml penicillin, and 100 μg / ml streptomycin) and seeded in plastic cell cultures treated in 96 wells at 1.6 × 10 ⁴ cells / ml. Cell viability was measured by MTT assay. The results showed that the absorbance at 550 nm increased from 24 to 48 hours in all conditions except for 25 μg / ml HC-HA, indicating that cell proliferation was usually controlled. It suggests proceeding in 1 to 100 μg / ml HA and 1 to 5 μg / ml HC-HA (FIG. 53).

Next, the effect of HC-HA or HA on the differentiation of MC3T3-E1 into osteoblasts was examined. MC3T3-E1 cells were resuspended in non-induced medium (1.6 × 10 ⁵ / ml), seeded in 96 wells and incubated to confluence. Uninduced medium is removed and induction medium 1 (complete medium with 0.2 mM ascorbic acid 2-phosphate and 10 mM glycerol 2-phosphate, manufacturer's instructions for in vitro osteogenesis assay kit, cat # ECM810, Millipore) was added. After 12 days of differentiation, alizarin red staining was used to measure and quantify osteoblast mineralization. The results showed that AR was actually stimulated by induction medium in the control. Consistent with previous reports (Kawano (2011) Biochemical and Biophysical Research Communications. 405: 575-580), AR staining was observed when 100 μg / ml HA but not 25 μg / ml HA compared to control. Further promoted. In contrast, AR staining was not reduced by 5 μg / ml HC-HA (p = 0.11) but was significantly reduced by 25 μg / ml HC-HA (p = 0.00002) ( FIG. 54). These results suggested that increasing HC-HA concentration during induction also reduced bone formation.

Example 38: Dose-dependent response for HC-HA and AMP on osteoblast differentiation using MC3T3-E1 model system.
Previous results indicate that HC-HA and AMP dose-dependently inhibit osteoclast differentiation from RAW264.7 cells induced by RANKL (see International PCT Publication No. WO 2012/149486). Indicated. AMP (Amnionic Membrane Powder) is a lyophilized and then finely ground form of amniotic membrane. In this example, the IC50 of HC-HA and AMP for bone formation is measured and compared with the IC50 for osteoclast formation.

  Alkaline phosphatase (ALP) assay and alizarin red staining (AR-S) are two assays used to measure the differentiation of MC3T3-E1 cells. ALP is secreted by osteoblasts and has long been a widely recognized biochemical marker for osteoblast activity (Sabobar (1994) Bone Miner. 27 (1): 57-67), Therefore, it functions as an early marker for bone formation. Alizarin red (AR) dye forms a chelate with calcium and hence AR-S is used to visualize mineralization. Since ARS dyes can be easily extracted, they can also be converted to mineralization quantification (Gregory et al. (2005) Analytical Biochemistry 329: 77-84).

Part A
Experimental design:
MC3T3-E1 culture Millipore In Vitro Osteogenesis consisting of α-MEM (Invitrogen, Cat. # ICM810) basal medium containing 10% FBS, 100 units / ml penicillin, and 100 μg / ml streptomycin. A model system of MC3T3-E1 cells from Kit was utilized. Cells were seeded at 50,000 cells / cm ² and cultured in 3O 0 C at 95% air and 5% CO ₂ in 100 mL cell culture dishes and passaged prior to confluence. Once a sufficient cell count was obtained, the cells were seeded at 1.6 × 10 ⁵ cells / ml in a 96-well culture dish with 100 μL volume of basic medium (52 wells) per well. Each concentration was performed in 4 wells, 2 wells for ALP assay and 2 wells for AR-S staining. Cells were cultured at 37 ° C. in 5% CO ₂ humidified air and the medium was changed every 48-72 hours to confluence.

  The dosage range investigated was derived from preliminary data performed on osteoblast differentiation (see above) and dose-response curves for HC-HA and AMP on osteoclast differentiation. HC-HA at 25 μg / ml markedly inhibited the growth and differentiation of MC3T3-E1 cells into osteoblasts and completely inhibited osteoclast differentiation from RAW264.7 cells (International PCT Publication No. 1). WO 2012/149486), which was selected as the highest concentration. 5 μg / ml HC-HA showed less than 50% inhibition, suggesting that the IC50 of HC-HA for osteoblast differentiation may be higher than the IC50 in P-214 Therefore, HC-HA concentrations in the range of 0.1, 0.5, 1, 5, 10, and 25 μg / ml were selected. Based on preliminary data on HC-HA, AMP was selected at the following concentrations: 1, 5, 25, 125, 250 μg / ml. Because ALP activity peaks at day 12 of differentiation in MC3T3-E1 cells (Maeda (2004) Journal of Cellular Biochemistry 92: 458 * 471; Wang, (2008) J Dent Res. 87 (7): 650- 654), chose to study bone formation on the 12th day after induction.

  After confluence, the media from each well was replaced with 100 μL Osteogenesis Induction Medium # 1. Osteogenesis Induction Medium contains 0.2 mM ascorbic acid 2-phosphate and 10 mM β-glycerin phosphate (In Vitro Bone Formation Assay Kit, cat # ECM810, Millipore). 10 μL working solution of AMP and HC-HA was added to Induction Medium # 1. AMP (AMP-4; Lot # CB102971, International PCT Publication No. WO 2012/149486) (5 mg / ml) and HC-HA (He et al. (2009) J. Biol. Chem. 284 in PBS. (30): 20136-20146) (250 [mu] g / ml) stock solutions were made and 0.1, 0.5, 1, 5, 10, and 25 [mu] g / ml and AMP for each experimental concentration (HC-HA) (1, 5, 25, 125, 250 μg / ml) according to the appropriate culture medium (Osteogenesis Induction Medium # 1). The medium was changed every 3 days.

  On day 6 of differentiation, the medium is replaced with 100 μL of fresh Osteogenesis Induction Medium # 2 containing ascorbic acid, β-glycerin phosphate, and melatonin. 10 μL working solution of AMP and HC-HA was added to 100 μL Osteogenesis Induction Medium # 2 (0.2 mM ascorbic acid 2-phosphate, 10 mM glycerol 2-phosphate and 50 nM melatonin solution, in vitro bone formation In addition to the manufacturer's instructions for the assay kit, cat # ECM810, Millipore), final experimental concentrations were obtained in the culture wells. The medium was changed every 2-3 days. Samples were then assayed by ALP assay (H-156) and ARS Staining Assay according to manufacturer's instructions (In Vitro Osteogenesis Assay Kit, (Catalog # ECM810)).

Alizarin Red S staining Medium from each well was aspirated without disturbing the cells. Cells were washed 1X with 200 μL PBS. The cells were added to 100 μL of 70% ethanol for 15 minutes. T.A. Fixed by incubating with. The fixative was then removed and the cells were washed away 3X (5 minutes each) with excess distilled water without interfering with the cell monolayer. Water was removed and 100 μL / well Alizarin Red staining solution was added. Wells were allowed to R.D. for 1 hour. T.A. Incubated with. Excess dye was removed and the cells were washed 4 × with deionized water (5 minutes light rocking with each wash). 0.1-0.15 mL of water was added to each well to prevent the cells from drying out. Stained cells were photographed under a microscope.

Thereafter, excess water was removed from each well. 100 μL of 10% acetic acid was added to each well and incubated for 30 minutes with shaking. The loosely attached monolayer was carefully removed with a cell scraper and the cells and acetic acid were transferred to a 1.5 mL microcentrifuge tube and vigorously stirred for 30 minutes. The sample was heated to 85 ° C. for 10 minutes and then transferred to ice for 5 minutes to cool the tube. The slurry in the tube was centrifuged at 20,000 xg for 15 minutes. 400 μL of supernatant was removed and transferred to a new 1.5 mL microcentrifuge tube. The pH was neutralized within the range of 4.1-4.5 with 150 μL of 10% ammonium hydroxide.
150 μL of each sample was added to a clear lower 96-well plate and read at OD ₄₀₅ . A plot of alizarin red concentration versus OD ₄₀₅ was generated.

ALP assay (BioAssay Systems: QuantChrom ALP Assay Kit, Cat. #: DALP-250)
Cells in each well (96 well plate) were washed with PBS and T.A. And dissolved in 100 μL 0.2% Triton X-100 in distilled water by shaking for 20 minutes. 200 μL distilled water and 200 μL Calibrator solution (supplied with the kit) were transferred to separate wells for controls. 50 μL of sample was transferred to separate wells. 150 μL working solution (200 μL assay buffer, 5 μL Mg acetate (5 mM), 2 μL pNPP liquid substrate (10 mM)) was added to the sample well (final reaction volume was 200 μL). The plate was mixed by tapping briefly. OD ₄₀₅ was read at 0 and 4 minutes on a plate reader.

Results Phase contrast microscopy The negative control maintained a hexagonal shape over 13 days of induction (Figure 55). The monolayer was smoother than the positive control, suggesting that more cells or more deposition of cells occurred in the latter. Cells in the positive control became spindle shaped after induction began. Over time, the spindle-shaped ring developed along the edge of the plastic culture (˜2-3 mm apart) around day 4 of induction.

  From 0.1 μg / ml HC-HA to 10 μg / ml HC-HA, the cell monolayer was not different from the positive control, because HC-HA at these concentrations had a negative effect on induction. This suggests that there was not (A in FIG. 55). Like the positive control, the cells also developed into a spindle shape and the monolayer developed into a spindle-shaped ring. However, at 25 μg / ml, a dramatic decrease in cell density and changes in cell morphology were observed on day 13 of induction.

  At concentrations above 25 μg / ml, AMP deposited particulate matter that settled onto the monolayer (FIG. 55B). As the AMP concentration was replenished after each medium change, AMP deposition on the top of the monolayer increased over the induction period. Since the cells also developed spindle shapes with spindle rings, treatment with AMP below 125 μg / ml did not affect cell morphology, which did not negatively affect induction. Suggests that. At concentrations above 125 μg / ml, the particle density of AMP increased to an extent that obscured the visual observation of spindle ring formation. However, the density and morphology of the cells remained the same as that of the positive control, confirming that AMP did not adversely affect the induction.

Alizarin red staining The negative control resulted in a blue-gray background with a monolayer portion showing light pink. In contrast, the positive control resulted in a rose pink background (Figure 56).

  0.1 μg / ml HC-HA resulted in a red rust color with reddish brown staining of the visible spindle ring, which was dramatically different from the color of the positive control (FIG. 56A). This trend continues from 0.5 μg / ml to 1 μg / ml with a slight lightening of color at 10 μg / ml, which maintains the mineralization from 0.1 to 5 ug / ml, from 0 to 0. It suggests that there may be a dose-dependent relationship between 1 ug / ml. At 25 μg / ml HC-HA, the red rust background disappeared and returned to a light purple pink with significant white gaps between cell junctions.

  AMP at 1 μg / ml to 125 μg / ml resulted in a dose-dependent discoloration from lighter brown rust (1 μg / ml) that appeared paler than 0.1 ug / ml HC-HA, The reaction was more gradual, suggesting a red rust background (5 μg / ml & 25 μg / ml), reddish brown (125 μg / ml), dramatically increasing to dark reddish brown at 250 μg / ml (FIG. 56). B). Particulate matter of AMP was seen on top of the cell monolayer treated with more than 5 μg / ml AMP and the particle size was smaller than the cells themselves and appeared to match the stained background color.

Quantitative analysis of OD values increased ARS staining by 0.1 μg / ml HC-HA treatment by 3 × from positive controls with statistical significance (p <0.05) (FIG. 57A). Some change in concentration from 0.1 μg / ml to 10 μg / ml is observed, which can be attributed to the small sample size (N = 2). A dramatic decrease in OD value was observed with 25 μg / ml HC-HA treatment. For AMP, treatment with 125 μg / ml AMP resulted in more than a two-fold amount of mineralization from the positive control, and was statistically significant (p <0.05) (FIG. 57B). A slight decrease in OD value from the positive control was seen at 1 μg / ml AMP, with a small dose-dependent increase in OD value from 1 μg / ml to 25 μg / ml. OD ₄₀₅ was reduced at 250 μg / ml AMP compared to 125 μg / ml. Some change may be due to the small sample size (N = 2).

ALP staining In both groups of AM derivatives, the negative control showed more than 5 times more ALP activity than the positive control, which could result from loss of sample in the negative control, reducing the sample size (Figure 58). . The smaller sample size contributes 8x higher standard deviation values relative to the negative control than the positive control, and this much larger change can be attributed to the increase.

  Induced MC3T3-E1 treatment with significant amounts of HC-HA reduced ALP activity compared to positive and negative controls (A in FIG. 58). ALP activity varied between different concentration groups, up to 25 μg / ml where ALP activity was significantly reduced. It is useful to note that there was little change from the mean in each experimental group and positive control.

  At 1 μg / ml, ALP activity was almost 4-fold higher than the positive control (FIG. 58B). This phenomenon was blocked at 5 μg / ml and 25 μg / ml, and ALP activity decreased approximately 3 × from the positive control. Increasing the concentration from 125 μg / ml to 250 μg / ml restored ALP activity to a level approaching 1 μg / ml. Thus, it appeared that ALP activity did not match the amount of mineralization.

Summary of Results Compared to the negative control, the positive control shows more spindle cells, forms a ring around the edge of the plastic well (FIG. 55A), and is discolored by alizarin staining (FIG. 56A). ), And a detectable but insignificant change in OD ₄₀₅ (FIG. 57A). MC3T3-E1 cells previously seeded in 5 × 10 ⁴ cells / 35 mm plastic dishes also formed lamellar collagen fibrils after 4 days, lamellar fibrils by 18 days, and 21 days The formation of nodular region was revealed by eye induction. (Sudo (1983) J. Cell. Biol. 96: 191-198). This prior study did not show the same ring formation we observed. Alternatively, it may have interpreted the ring as a layered collagenous fibril. If so, the ring region should be prone to mineralization.

Alizarin red staining is described as crimson in the literature to indicate mineralization. Mineralization and osteoblast nodules are described as stained red, and the intensity of the color increased with mineralization (Wang, (2006) Biotechnol. Prog. 22 (6): 1697-701; Zhao, 2007). ARS staining is read at 405 nm, which corresponds to a violet color in the visible spectrum. Unlike our results, color photographs of ARS staining of MC3T3-E1 mineralization from published data showed no red rust or reddish brown color in the monolayer. The darker color in our results indicates more ARS staining and hence more bone formation compared to the published results. The amount of OD change in ARS staining and quantification varied depending on the culture conditions and cell type. Human mesenchymal stem cells (hMSCs) cultured in 6 wells (10 cm ² / well) for 30 days achieved an increase in OD ₄₀₅ of 0.5-4 (Gregory et al. (2005) Analytical Biochemistry 329: 77-84). MC3T3-E1 cells (α-MEM, ascorbic acid, α-glycerin phosphate) cultured in a 24-well plate for 28 days achieved an OD of 0.6. However, the ODs on days 16 and 26 were less than 0.05 and 0.2, respectively, and much less than day 28 (Burkhardt (2006) University of Basel, Master Thesis). The lack of dramatic discoloration in the positive control may be due to the D13 time, which is optimal for ALP but too short for ARS.

  0.1 μg / ml HC-HA is also 3X higher than the “ring change” (FIG. 55A), apparent color enhancement (FIG. 56A), and positive control (p <0.05). Induces OD values (FIG. 57A), indicating that HC-HA at lower doses promotes mineralization and dose-response curves are between 0 and 0.1 ug / ml It suggests.

0.5-10 μg / ml HC-HA also shows a “ring” (FIG. 55A), maintains the same color as 0.1 ug / ml (FIG. 56A), with no statistically significant difference Resulting in OD ₄₀₅ . HC-HA at 25 μg / ml reduces cell density, changes cell morphology, loses the “ring” (FIG. 55A), and does not cause discoloration (similar to the negative control) (FIG. 56). A), and insignificant OD ₄₀₅ (like a negative control) was produced.

AMP from 25 μg / ml left particulate matter (FIG. 55B) and increased color with a positive dose-response relationship from 1 μg / ml (FIG. 56B), but OD ₄₀₅ showed an increase that was not statistically significant up to 125 μg / ml AMP (p <0.05) and then decreased at 250 μg / ml, which was not consistent with discoloration. Unlike HC-HA, higher doses of AMP did not cause adverse effects on cell morphology.

Part B
Thereafter, alizarin red staining increases sample size and is used for alizarin staining of human MSCs and other methods known in the art, Gregory et al. (2005) Improved by incorporating methodology according to Analytical Biochemistry 329: 77-84). A comparison of the method of Gregory et al, our previous method described above, and the new scheme outlined in this example is provided in the table below. Previous studies have shown that differentiation of MC3T3-E1 under induction is in three stages: proliferation (days 1-9), ECM formation (days 9-16), and mineralization (in the formed ECM) It has been shown that it can be subdivided into deposit minerals (day 16+). (Quarles et al. (1992) Bone Miner Res. 7 (6): 683-92; Hong et al. (2010) Exp Cell Res. 316 (14): 2291-300). In order to compare studies from different groups, it was important to set the event starting at confluence as day 0.

Experimental design:
Cells were cultured and stimulated in differentiation medium as described in Part A and Table 5. Differentiation medium was changed every 3 days for 18 days. 0.1 μg / ml HC-HA and 125 μg / ml AMP were utilized for the assay. The ARS assay was performed as described in Part A with changes as noted in Table 5.

Results Cell morphology and ring formation Uninduced cells achieved a horizontal cube shape after seeding (FIG. 59A). The cell boundaries were more demarcated with a raised edge on the 4th day, and some cells developed a spindle shape on the 6th day. Spindle cells or multilayers were not developed.

  From day 1 to day 3, the cells maintained a cubic shape and the monolayer remained flat (FIG. 59B). By day 3, cell boundaries became clearer and cell edges were raised. In addition, small circular cell-like structures were visible on the monolayer (indicated by black circles). Cell morphology changed by day 4 with the appearance of fusiform cells and cells organized in multiple layers. The appearance of small round cell-like structures continued to increase from day 6 to day 7.

  Changes in cell morphology of induced cells treated with HC-HA reflected changes in the positive control (A in FIG. 60). HC-HA did not leave particulate matter on the monolayer like AMP. Like the positive control, small round cell-like structures (indicated by black circles) appeared on day 3 and continued to increase until day 7.

  Particulate matter of AMP (indicated by black arrows) settled on top of the monolayer, preventing observation of the monolayer just below (B in FIG. 60). The areas lacking particulate matter of AMP on day 0 and day 1 showed circular and cubic shapes. On the second day, some fusiform cells appeared on the monolayer. It is difficult to identify and distinguish small circular cell-like structures from smaller AMP particulates, and the development of these structures remains unknown. On the fifth day, the spindle shape stretches to form spindle-like cells. On day 6, long spindle cells formed a web-like interaction with AMP particulate matter (indicated by black circles).

  On day 3, fusiform cells developed near the edge of the well (1-2 mm from the edge) (A in FIG. 61). Spindle cell and ring formation did not develop after day 4. The cells appeared to overlap each other at the edge and grow into a spindle shape. From day 0 to day 2, there were no spindle cells along the edge of the well (FIG. 61B). On the third day, similar spindle cells deposited in a ring configuration were seen at the rim. From day 5, these cells were concentrated as a prominent ring about 2 mm from the edge. On day 6, the monolayer shows separation from the plastic surface along a specific area near the edge (indicated by white →).

  The cells remained smooth and cubic along the edge until day 2 (A in FIG. 62). Spindle-shaped cells developed near the rim on the second day. At that time, there were also small round-cell-like structures that were visible near the edges. Spindle-like cells developed on day 3 and continued to thicken in the ring around the edge of the well until day 5. Separation of the monolayer from the plastic well was observed on day 6 in the area near the edge (indicated by the white arrow). Spindle-like cells appeared on the second day near the edge of the well (FIG. 62B). Spindle-like cells developed from the edge on day 3 (about 1-2 mm apart), and spindle-like cell rings formed by day 5. Separation of monolayers from plastic wells was observed in several areas near the edge on day 5. Separation continued on day 6, but the monolayer did not separate as much as cells treated with HC-HA and positive control cells.

ARS staining and quantification The negative control monolayer was stained pale pink in several areas (FIG. 63). The positive control stained light pink in the center, but showed a bright crimson color in the area of the spindle ring, indicating that MC3T3-E1 cells deposited more mineralization in the ring than the rest of the monolayer Shows that Both the intensity and color of staining in the central monolayer and spindle ring between 0.1 μg / ml HC-HA and the positive control were the same. The particulate matter of AMP at the top of the cells was stained reddish brown. Visual observation of the cells directly underneath was disturbed by the stained particulate matter, but the openings showed a pronounced lack of cell monolayer and, similar to the negative control, a low density that was stained pale pink There were also cells. Cells treated with AMP did not show a visible spindle ring and ARS did not stain crimson around the edges, similar to the positive control.

  GnHCl treatment solubilized the cell matrix and removed the crimson ARS dye, but the monolayer remained intact in both the positive control and HC-HA treated cells. GnHCl digested and denatured cellular proteins, leaving an extracellular matrix. In the experimental group of AMP, the particle density of AMP decreased, but most of the particulate matter remained at the bottom of the well. With long incubation times, AMP particulates can form a close interaction with the ECM matrix that was not dissolved by GnHCl. The particulate matter, once dyed light reddish brown, showed a light brown color similar to the color originally shown by AMP. However, a different monolayer structure was not observed; this supported the observation of cell monolayers in the inter-AMP gap. Cells may migrate from the monolayer to AMP particulate, which was used as a scaffold for differentiation and mineralization.

The ARS standard showed a progression from deep red to cream pink with serial dilution from 2 mM to 31.3 μM (A in FIG. 64). There was significant discoloration between the HC-HA and AMP treated samples. The cell extract treated with HC-HA showed a light cream color, while the cell extract treated with AMP showed a light cream pink color. The negative control also showed the same color and level of color intensity as the HC-HA treated cells, while the positive control showed a lighter color than the lighter and resembled a blank (not shown). It was. The OD ₄₀₅ value remained within the same range as the previous example value (B in FIG. 64). Compared to the negative control, the positive control showed a statistically significant 2-fold decrease in OD. HC-HA treated (0.1 μg / ml) cells showed a slight increase in OD over the positive control, but the difference is not statistically significant. AMP (125 μg / ml) treatment slightly reduced the OD value compared to the positive control, but this decrease was not statistically significant.

The ARS standard showed a progression from crimson to cream pink with serial dilution from 2 mM to 31.3 μM (FIG. 65A). The negative control extract showed a light cream color slightly darker than the blank (not shown). The positive control showed a light golden color and its color was visibly darker than the negative control. HC-HA also showed a light golden color with the same intensity as the positive control. The AMP-treated extract showed a darker orange gold color than both the positive and HC-HA extraction groups. The OD ₄₀₅ value remained within the same range as the highest range at approximately 0.25 (B in FIG. 65). The negative control showed a negligible OD value close to 0. Extracts treated with positive control and HC-HA (0.1 μg / ml) showed mean OD values close to 0.05.
The AMP treated (125 μg / ml) extract showed a statistically significant 5-fold increase in OD (P = 0.039) from both the positive and HC-HA treatment groups.

Summary Cell Morphology MC3T3-E1 cells cultured in αMEM w / 10% FBS grew to confluence and developed a cubic shape. As the results in Aim # 1 and # 2, the cells did not differentiate without the addition of ascorbic acid, β-glycerin phosphate, and melatonin. Without induction medium, spindle cells and spindle rings were not formed (FIG. 59). MC3T3-E1 cells were induced to differentiate by ascorbic acid, β-glycerin phosphate and melatonin. After sowing, a smooth monolayer was formed by cubic shaped cells. After 3 days of induction, the cells achieved a spindle shape. By day 5, the cells had stretched and became spindle shaped.

  In this example, the spindle ring developed on the third day of induction, and spindle-like cells were formed 1-2 mm from the well wall. On day 6, separation of the monolayer from the edge of the well and the bottom of the plastic was observed (Figure 60). Small round cell-like structures began to develop on the monolayer on day 2 and increased in number on day 6 (FIG. 59). They did not float in the medium, adhered tightly in the monolayer and rested mainly between the cell boundaries. These structures indicate that matrix vesicles (MV) are extracellular, membrane-invested particulate matter located at the site of early calcification in cartilage and bone . The synthesis of matrix vesicles occurs by the germination and picking of vesicles from specific regions of the plasma membrane external to the chondrocytes and osteoblasts of the growth plate that buds and differentiates (Anderson et al. 2003) Curr Rheumatol Rep. 5 (3): 222-6).

  Treatment with HC-HA did not alter the cell morphology change of MC3T3-E1 due to differentiation (FIG. 60). The formation of spindle-shaped cells, spindle-shaped cells and spindle rings followed the reported time course of the positive control (FIG. 61). AMP particulates settled on top of the cell monolayer, similar to previous results (FIG. 60). This prevented adequate observation of cell monolayer and cell morphology changes upon induction. However, in some cases, the AMP particulate matter was observed through an opening in which the AMP particulate matter did not settle. Unlike HC-HA, AMP treatment promoted cytomorphological changes and some spindle cells were visible one day early on the second day of induction. AMP-treated cells formed spindle rings similar to HC-HA-treated cells and positive controls (FIG. 62). However, the monolayer separated earlier than the other two experimental groups (day 5 instead of day 6) (FIG. 62).

AR staining and quantification ARS staining showed a dramatically different color than previously reported (Figure 66). ARS stained light pink instead of gray blue in the negative control cell monolayer. ARS staining also showed a bright crimson color enriched in the spindle ring instead of tea rust color from previous results in positive control and cells treated with HC-HA. The particulate matter of AMP was stained with reddish brown instead of dark brown, and the cells underneath were stained light pink instead of tea rust. Degradation of the ARS solution can contribute to discoloration.

  After acetic acid extraction, it appeared that a significant amount of stained color still remained in the monolayer. Acetic acid is not effective in removing ARS staining completely from the monolayer. With acetic acid extraction, there was a statistically significant difference between the OD values of the positive and negative controls (FIG. 68), consistent with visual observation of more ARS staining in the positive control (FIG. 66). However, although visual observation of the AMP group has more color in the assay extract than the other two groups (FIG. 67), the acetic acid extraction is positive and the HC-HA group Compared to (Figure 66), it was not effective to show a statistically significant increase in AMP OD. AMP particle deposits may make it more difficult to remove ARS from the AMP population. The mineralized matrix and cells may also have interactions with AMP particulates that interfere with acetic acid extraction of ARS.

  GnHCl removed ARS more completely from the cell monolayer than acetic acid treatment (FIG. 69). Furthermore, the color became soluble in the GnHCl solution without the use of a cell scraper to remove the monolayer. By both methods, the particulate matter remained invisible to the naked eye and did not appear to be affected by centrifugation. For GnHCl, this can be a dissolved matrix that forms calcium and fine powder. This resulted in a change between iterations in each sample. Reading at 670 nm to remove particulate matter solved this problem for the GnHCl extraction method.

  GnHCl extraction failed to establish quantifiable statistical significance between negative and positive controls, consistent with visual observation of ARS staining (FIG. 71). GnHCl extraction also showed that 0.1 μg / ml HC-HA did not promote further mineralization in differentiating MC3T3-E1 cells (FIG. 71), consistent with the results of acetic acid extraction . Looking closely at the color of the assay extract in 96 wells showed no difference in color or intensity in the positive control and HC-HA wells (FIG. 70).

  GnHCl extraction showed that 125 μg / ml AMP promoted more mineralization in differentiating MC3T3-E1 cells than the positive control (FIG. 71). This is consistent with both monolayer ARS staining (FIG. 66) and visual observation of extracts in 96-well assay plates (FIG. 70), where AMP is much more than HC-HA or positive controls. Showed a deep yellow-orange color.

  From these results, GnHCl is a more suitable extraction method because it more completely removes ARS staining from the monolayer and leaves it intact; it is less technical because the monolayer does not have to be scraped from the well. There is no error. The color of the extract can be quantified by spectrophotometer reading.

Part C
The preliminary studies described above do not show statistically significant results for dose-response curves for HC-HA and AMP on osteoblast differentiation due to the small sample size and incomplete development of the ARS assay It was. This suggested that 0.1 μg / ml HC-HA could enhance mineralization. Furthermore, HC-HA at 10 μg / ml to 25 μg / ml may affect cell viability and reduce mineralization. The dose curve for HC-HA should include lower concentrations below 0.1 μg / ml as well as concentrations above 10 μg / ml. Unlike HC-HA, AMP at 5 μg / ml to 125 μg / ml can promote mineralization. In this experiment, the dose response of HC-HA and AMP was retested using the Part B method. In this experiment, ARS staining was used to assay on day 15 and utilized a modified protocol using 10% acetic acid to stain and quantify.

Experimental design The same model system as shown in Part B based on 3T3-E1 cells was used by seeding 3 × 10 ⁴ cells / cm ² / well in 96 well plates in αMEM medium w / 10% FBS. . Following confluence, cells were induced to differentiate by adding induction medium for ascorbic acid, β-glycerin phosphate, and melatonin.
For each condition, N = 3 was tested. After confluence (Day 0 = seeding), HC-HA was added at 0.02 μg / ml, 0.1 μg / ml, 1 μg / ml, 5 μg / ml, and 25 μg / ml, while AMP was added at 1 μg / ml. ml, 5 μg / ml, 25 μg / ml, and 125 μg / ml. The modified method of Part B was used for ARS staining.

Results The negative control MC3T3-E1 cells did not develop a spindle shape or spindle ring during culture (A in FIG. 66). The center and periphery of the monolayer were stained beige. The positive control cells developed spindle and spindle cells and a spindle ring appeared around D5 that was cultured (induced on day 4). ARS staining showed a light maroon color in the center and was mainly concentrated in the spindle ring with a deep crimson color. Increasing the HC-HA concentration to 1.25 μg / ml had no effect on cell morphology or intensity and pattern of ARS staining. At 2.5 μg / ml, the spindle ring of MC3T3-E1 cells began to degrade and the color of ARS changed from deep red to reddish brown. By 20 μg / ml, the cells lost their spindle and spindle shape; the edges of the cells were not well defined and raised much. Cell density decreased and monolayers were not raised and appeared as before. GnHCl succeeded in extracting the ARS dye, and the coefficient of variation of the OD ₄₅₀ value ranged from 5% to 19%. The positive control showed a statistically significant increased OD value (FIG. 66B).

Negative control MC3T3-E1 cells did not develop spindle shape or spindle ring during culture (FIG. 67A). The center and periphery of the monolayer were stained beige. The positive control cells developed spindle and spindle cells and a spindle ring appeared around D5 that was cultured (induced on day 4). ARS staining showed a pale maroon color at the center of the monolayer. AMP treatment left particulate matter of AMP that settled to the top of the cell monolayer and obscure the monolayer observation from an upward concentration of 62.5 μg / ml. MC3T3-E1 cells treated with AMP alone and without induction showed no spindle ring along the edge, and ARS staining showed a deep crimson color on a pale pink background. From 7.8 μg / ml to 31.25 μg / ml, AMP particulate material did not completely cover the monolayer, and the cells exhibited spindle and spindle shapes. A spindle ring was not seen along the edge. ARS staining showed a central monolayer stained pale maroon and a pigment that was concentrated in a deep crimson color as a positive control along the spindle ring. GnHCl succeeded in extracting the ARS dye and the coefficient of variation of the OD ₄₅₀ value ranged from 3% to 10% (67 B).

Summary of Results Cell Morphology / ARS Staining Similar to the previous results, MC3T3-E1 differentiation proceeds from cells that change from a cubic shape to a spindle and spindle shape. As the induction time increases, a spindle ring is formed along the edge of the well (˜2 mm apart), causing the monolayer to shrink over time. Unlike the positive control, the negative control never developed spindle-like cells or spindle rings. The negative control monolayer was stained with a uniform beige color, while the positive control showed a light maroon / pink color in the center and a deep crimson color concentrated on the spindle ring.

  At 10 μg / ml HC-HA, the cell morphology changed from a lower concentration and fewer cells showed spindle and spindle shapes. The cell density decreased and the monolayer appeared to be less prominent. At 20 μg / ml HC-HA, the cell density decreased dramatically and there were few spindle shaped cells. The monolayer appeared not as smooth as the negative control. For both concentrations, these changes were found to begin with day 5 culture and induction. At both concentrations, the spindle ring was poorly formed or was not present. An increase in HC-HA concentration caused the spindle ring to collapse at concentrations of 2.5 μg / ml and above.

  In all AMP-treated cells, the area around which the AMP particulate matter settled was stained deep dark red. No monolayer was seen around the edge of the well through the opening of the AMP particulate. Uninduced MC3T3-E1 treated with 125 μg / ml AMP showed staining similar to induced MC3T3-E1 treated with 125 μg / ml AMP. Cells with precipitated AMP were stained deep dark red in the patch, and no monolayer stained beneath was observed. Cell morphology was visible at AMP from 7.8 μg / ml to 15.6 μg / ml. The cells showed spindle and spindle shapes, and a spindle ring was formed along the edge of the well. ARS staining was similar to a positive control with a light maroon color in the center and a deep crimson color in the spindle ring area.

GnHCl treatment successfully extracted ARS dye from the stained monolayer. Extraction showed a statistically significant (p <0.01) 2-fold increase in OD ₄₅₀ from negative control to positive control. HC-HA treated cells showed a tendency to decrease mineralization as HC-HA concentration increased. At 10 μg / ml and 20 μg / ml HC-HA there was a statistically significant (p <0.05) reduction in mineralization from the positive control. AMP dose-dependently increased mineralization of differentiating MC3T3-E1 cells.

  Non-induced cells treated with AMP also showed mineralization, and AMP appeared to induce and promote mineralization over the positive control (p <0.01). Also, treatment of uninduced cells with 125 μg / ml AMP showed mineralization over cells cultured in induction medium (p <0.05).

Example 39 Effect of AMP on Osteoblast Differentiation ARS staining showed a clear dose-dependent increase in staining with AMP, showing a statistically significant increase in mineralization at 125 μg / ml, such as It was unclear whether the change was caused by nonspecific binding of ARS to AMP. AMP acted differently from HC-HA, especially at high doses, ie it promoted mineralization but did not inhibit it, so the effect of AMP depends on direct cellular contact with AMP It was important to exclude whether or not. This problem was addressed by the use of a transwell with a 3 μm pore size that is sufficient for HC-HA to pass through, but small enough to eliminate AMP particulate matter. Since available transwell plates with this pore size fit 24 well plates, the assay culture conditions were changed accordingly. A concentration of 125 μg / ml AMP was used for the assay.

Experimental design:
MC3T3-E1 cells (cells in P2; ATCC, catalog number: CRL-2593 ™) were seeded onto 12 well horizontal, clear bottom wells at a density of 1 × 10 ⁵ cells / ml. The same stock solution of AMP used above (AMP-4; Lot # CB102971) was prepared as 5 mg / ml in PBS. For wells without transwells, 17.5 μL of AMP stock solution is added in 0.7 ml culture medium (base or induction medium) and α-MEM w / 10% FBS (no induction) or induction medium. A concentration of 125 μg / ml AMP was achieved in either # 1 followed by # 2 (with induction). For wells with transwells, 17.5 μL of AMP stock solution was added directly to the center of the transwell membrane in the same manner as described above. Culture medium (α-MEM with 10% FBS; induction medium # 1 and # 2 as described above) was changed every 3 days after induction on day 0. The ARS staining and quantification procedure is described above, except that the cell monolayer was fixed with 4% paraformaldehyde instead of 70% ethanol and stained for 2 hours instead of 1 hour. I went so that.

Results All induced cells developed ring formation on day 4 of induction (Figure 68). The ring was composed of a layer of cells around the edge of the plastic well, about 2-3 mm apart. They grew and wrapped in layers, after which the monolayer was separated from the plastic in many wells. Without induction, the cells maintained some spindle shape and predominantly hexagonal shape with increasing culture period, and the monolayer remained smooth compared to the induced cells (FIG. 69). Induction caused the cells to be spindle-shaped, the monolayer was raised, and the boundaries between cells became clearer. By induction, by day 4, a spindle-shaped ring was observed to develop along the edge of the culture dish. Treatment with AMP did not affect cell viability; nor did it affect ring formation, suggesting that it did not adversely affect AMP induction. The addition of transwell did not affect cell growth or morphology.

  Without transwell, AMP at 125 μg / ml left the particulate matter settled on the cell monolayer (FIG. 69A). Without induction, the AMP itself causes the cells to develop a spindle shape and no ring is generated, so this is not enough for AMP alone to cause induction, similar to the negative control. It suggests that there was not. Upon induction, 125 μg / ml AMP resulted in a change in cell morphology like the positive control, suggesting that AMP itself did not adversely affect the induction. By transwell, 125 μg / ml AMP left insignificant particulate matter on the cell monolayer (FIG. 69B). Without induction, AMP was not sufficient to induce cell differentiation and cells were similar to negative controls. With induction and 125 μg / ml of AMP, the cells developed spindle and spindle shapes and resembled the positive control until day 14, which also suggested that AMP did not adversely affect the induction doing.

The negative control resulted in a dark gray background with a light pink patch in the monolayer, which was different from the gray gray of the negative control in previous experiments (FIG. 70). Although not induced by transwell, the monolayer was stained with a dark gray background, similar to the negative control, even when treated with AMP, suggesting that AMP itself did not cause induction. doing. Without the transwell, there is a region that shows a marked decrease in background color compared to the negative control, which is the color of the AMP particulates deposited on the monolayer (marked by ^** ). Indicating that AMP itself did not produce a positive color, thus suggesting mineralization.

  The positive control resulted in a rose pink with a red rust-stained ring that was darker than the deep red from the positive control in the previous experiment. The addition of the transwell did not affect the color of the positive control, confirming that the transwell itself did not affect the induction. In the absence of AMP but no transwell, the monolayer resulted in a darker red rust color than the positive control, and the ring was stained darker, suggesting that AMP exerted further positive induction. In contrast, transwell reduced the intensity of the background color to the level of the positive control, while the ring maintained the same color, which had an adverse effect on the effect of AMP on induction. It suggests that.

Quantification results were not sufficient to produce statistical significance and did not match the visual analysis of ARS staining (Figure 71). However, the overall trend suggested that the positive control showed more mineralization than the negative control. Furthermore, there was a tendency for transwells to suggest less OD ₄₀₅ when included in the presence and induction of AMP.

Summary of results Perhaps the size of the dish was larger, so ring formation was readily observed (A in FIG. 69). However, the background color for the negative control was different from the previous experiment, probably due to a fixative change. Furthermore, there was a more dramatic discoloration between the negative and positive controls, especially in the ring area (FIG. 70). Introduction of transwells in the positive control did not affect cell morphology (Figure 69B) or ARS staining color (Figure 70).

  Without induction, AMP without transwell clearly blocked positive ARS staining (FIG. 70), and AMP with transwell showed the same color as the negative control. AMP itself does not cause non-specific ARS and does not cause induction. Upon induction, AMP without transwell resulted in more color than the positive control. In contrast, AMP with transwell appeared to give the same color as the positive control.

  Previous ARS quantification results showed 125 μg / ml of AMP promoting 3X more mineralization than the positive control (p <0.05) (FIG. 67), but not in FIG. 71.

  There was no difference in cell morphology between cells treated directly with AMP and cells treated with AMP via transwell (FIGS. 69A, B). Both cell groups developed ring formation and visual observations showed no discernable differences between the ring structures. ARS staining showed insignificant differences in background color between the two experimental groups. However, cells treated directly with AMP show more diffuse ring formation, which may be a scattering effect from particulate matter of AMP (FIG. 70).

  AMP does not require direct contact with MC3T3-E1 cells to affect mineralization. Although it is unclear whether AMP promotes mineralization from this experiment, it has been shown that AMP does not affect cell morphology or cell viability (FIG. 69).

Part B
Our results showed that 125 μg / mL AMP significantly increased the mineralization of MC3T3-E1 cells (FIG. 65) when compared to the positive control on day 15 of growth and differentiation. AMP is delivered directly to the medium and AMP particulate settles on top of the cell monolayer; therefore, the effect of AMP on Aim 1B required direct contact.

  In Part A, investigate whether the effect of AMP is due to its action as a scaffold for differentiating MC3T3-E1 cells, or whether the factor is released from particulate matter to promote mineralization did. However, small sample sizes and technical errors in extracts of ARS staining with 10% acetic acid affected the data and no statistically significant differences were seen. The experiment was repeated using the improved technical method of ARS staining and extraction developed in Example 38 using 4M guanidine HCl.

Experimental design:
MC3T3-E1 cells were seeded at 3 × 10 ⁴ cells / cm ² / well in 24 wells using αMEM medium + 10% FBS as described above. After confluence, cells were induced to differentiate by adding ascorbic acid, β-glycerin phosphate, melatonin. For each condition, N = 3 was tested. Day 0 was considered as the day of cell seeding and induction continued after cell confluence. Total induction time = 15 days. There were two experimental groups: AMP was added directly to the induction medium and AMP was delivered by transwell. The concentration of AMP was maintained as before at 125 μg / ml. A negative control (no induction) was added with or without AMP but without an insert. As described above, ARS staining and quantification was performed on day 15 of induction.

Results Without induction medium, negative control cells maintained a hexagonal shape with several spindle shapes (FIG. 72A). A spindle-like shape was not observed and no spindle ring was formed along the periphery. ARS stained the monolayer in light pink. Upon induction, positive control cells achieved a spindle shape. The cell boundaries were more prominent and raised; a spindle ring was formed along the periphery near the edge of the well. The center of the monolayer was stained maroon and the ARS stain was concentrated in a spindle ring with a strong crimson color. Directly upon treatment with AMP, the particulate matter of AMP settled onto the monolayer, obscuring the cell morphology. However, near the edge of the culture well, the gap between the AMP particulates showed a marked lack of monolayer directly under both groups. There was no difference in cell morphology between AMP treatment alone and AMP treatment with induction. Visible cells were spindle shaped. No spindle ring was observed as a positive control. ARS staining showed a deep red color in the center and a reddish brown staining along the periphery. The staining color and pattern were indistinguishable between the induced group and the non-induced group. Treatment with AMP through the transwell did not result in sedimentation of AMP particles on the monolayer. The cells stretched and became spindle-shaped, forming a spindle ring along the edge of the well. As a positive control, the center of the monolayer was stained maroon and the ARS dye was concentrated in a spindle ring with a strong crimson color. GnHCl succeeded in extracting the ARS dye, and the coefficient of variation of the OD ₄₅₀ value ranged from 2% to 15% (B in FIG. 72).

Summary of results Morphology / ARS staining Negative controls cultured in α-MEM w / 10% FBS for 21 days did not develop spindle-like cells or spindle rings along the edge. Positive controls after 20 days induction with AA, β-glycerophosphate, and melatonin, MC3T3-E1 cells developed spindle-like cells and spindle rings around the edge of the well (FIG. 72). Cell monolayer ARS color and staining patterns differed between negative and positive controls. The negative control monolayer did not collect as much dye as the positive control and showed a uniform light pink color. The center of the positive control monolayer was stained maroon and the ARS dye was concentrated in the spindle ring to a strong crimson color (FIG. 72).

  Treatment with direct AMP in culture medium obscured the observation of cell monolayers in AMP and AMP with the induction group due to sedimentation of particulate matter in AMP. However, the spindle ring along the edge of the well was not observed and some cells along the edge showed a spindle-like morphology. The opening through which the AMP particulate material passed showed the lack of a monolayer directly underneath. ARS staining showed that there was no color or pattern difference between the AMP alone group and the AMP with the challenge group.

  Treatment with AMP through the transwell did not result in AMP particulate material on top of the monolayer. The cell morphology was similar to the positive control, with spindle-like cells and a spindle ring formed. The color and pattern of the ARS staining was also similar to the positive control, the background monolayer was stained maroon and the ARS staining was deep red and concentrated in the spindle ring.

AR quantification GnHCl was necessary and sufficient in the extraction of ARS staining from monolayers. When comparing the controls, there was a statistically significant 2-fold increase in OD ₄₅₀ from the negative control to the positive control (p <0.01). There was also an approximately 6-fold increase in OD from negative / positive controls to AMP + induction. There is a 6.5x increase in surface area from 96 to 24 wells, which can cause an increase in OD. Also, ARS staining and quantification is performed on the 20th day culture, which can extend the culture period by 2 days and increase mineralization.

AMP alone induced a statistically significant 10-fold (p <0.01) and 3-fold (p <0.01) increase in OD ₄₅₀ values from negative and positive controls, respectively. Thus, AMP alone was sufficient to induce and promote differentiation. AMP with induction slightly reduced OD ₄₅₀ from AMP alone (p <0.05), but showed a 3-fold increase in OD from the positive control (p <0.01). Induction medium prevented differentiation and mineralization.

  AMP delivered via transwell with induction showed that OD that was 3 times lower than AMP was delivered directly by induction (p <0.01), positive control (p <0.05). ) Slightly lower OD. AMP requires direct contact to promote differentiation. Without direct contact, AMP inhibits MC3T3-E1 mineralization.

Example 40: Effect of AMP on induction of bone formation in MSC Our results showed that AMP promotes differentiation of MC3T3-E1 when in contact with preosteoblasts. However, it is unclear how AMP affects the growth and differentiation of less differentiated and less committed cell lines for osteoblast cell lines such as mesenchymal stem cells (MSCs). there were.

  MC3T3-E1 cells are pre-osteoblasts and are unipotent and therefore require only supplements to drive their differentiation into osteoblasts. Other progenitor cell lines, such as embryonic stem cells (ESC) or mesenchymal stem cells (MSC), are less differentiated and are pluripotent and pluripotent, respectively. Therefore, by studying the effects of AMP on MSCs derived from different regions of the human body, a better understanding of the role of AMP in osteoblast differentiation programming and related factors can be obtained. This test can narrow down the answer to what cell type AMP affects and what effect it has on inducing bone formation in different progenitor cells.

Experimental design The following cell lines were used: MC3T3-E1 (ATCC, Manassas, VA), mesenchymal stem cells derived from human bone marrow cells (Lonza, Walkerfield, MD), Niche cells derived from corneal limbus (Tissue Tech, Miami, FL), human amniotic membrane (hAM) stromal cells (Tissue Tech, Miami, FL), and human umbilical vein endothelial cells (HUVEC) (ATCC, Manassas, VA).

Cells were seeded in 96-well plastic culture dishes at 3 × 10 ⁴ cells / cm ² / well in αMEM medium + 10% FBS. After confluence, the cells were induced to differentiate osteoblasts by adding ascorbic acid, β-glycerin phosphate, and melatonin (AGM). For each condition, N = 5 was tested. Total induction time = 20 days. Day 0 was considered as the day of cell seeding and induction continued after cell confluence. Each cell type had the following three experimental groups: negative control, positive control, and AMP treatment only. For AMP treatment, an AMP concentration of 125 μg / ml was used. The medium (100 μL) was changed every 3 days for a 20 day culture period. A negative control with AMP (no induction or cells) was added. ARS staining and quantification was performed on day 20 as described above. The extract was then read at 450 nm.

Results HUVEC cells formed a reticulated pattern of cell growth by day 4 (FIG. 74A). However, there was cell death, and dead cells had settled on top of the cell net until day 21. Most HUVEC cells could not be fixed with 10% paraformaldehyde and few cells stained with ARS showed a dark brown color. AMP settled on top of the HUVEC cells and covered the cell network, but the AMP particulates were separated from the plastic wells by the cells after ARS staining; Stained brown.

  hBM MSCs maintained a long fibroblast shape without induction (FIG. 74A). Upon induction, MSCs were stretched by more raised cell edges by day 4. By day 10, the induced MSCs developed spindle-like cells that developed layers that overlap each other on the monolayer. On day 17, the overlapping spindle cells formed a dense ring about 5 mm from the center of the well. ARS staining showed that the uninduced MSC monolayer was stained cream and the spindle ring was stained red-orange. The AMP-treated MSC contained AMP particulate material that covered the monolayer. Over time, the monolayer shrunk near a concentrated region of AMP particulate. ARS staining showed a deep reddish brown color.

  hAM stromal stem cells maintained a rectangular shape without induction (FIG. 74A). By day 4, the induction changed the cell morphology and the cells stretched with several developing spindle shapes. AMP particulates settled and covered some of the monolayer by day 4 in AMP-treated stromal cells. The cells that were not covered with AMP particulate matter on the fourth day were rectangular. By day 17, cells that were not covered by AMP particulates were stretched similar to the induced cells in the positive control. By day 21, AMP particulate matter covered the well and cell morphology could not be observed. ARS staining showed that uninduced cells stained cream, while induced cells stained light pink. AMP-treated cells stained dark reddish brown, similar to AMP-treated hBM MSCs.

4M GnHCl and the extract produced a coefficient of variation within the OD ₄₅₀ value ranging from 2% to 15% (FIG. 74B).

Summary of results The results showed that either the inducer or AMP showed no mineralization in the HUVEC negative control. For both hBM MSC and hAM stromal stem cells, mineralization was promoted by the inducer, which was less than that promoted by AMP.

Example 41 Effect of AMP on Mineralization and Cell Proliferation During MC3T3-E1 Differentiation MC3T3-E1 cells undergo three major steps before becoming mature osteoblasts: proliferation, matrix deposition / Maturation and mineralization (Figure 75). Our results showed that AMP promotes mineralization in MC3T3-E1 cells. Considering ARS staining, it shows that cells treated with AMP stained darker and more densely than positive and negative controls (FIG. 72). Furthermore, when the AMP particulate material covered the monolayer, the monolayer directly beneath the AMP particulate material was absent (FIG. 77). One possibility is that AMP was acting as a scaffold for MC3T3-E1 cells, and this interaction in the 3D matrix caused the cells to grow and mineralize. Thus, AMP may promote mineralization by increasing the proliferation of MC3T3-E1 cells.

Experimental Design MC3T3-E1 cells were seeded at 3 × 10 ⁴ cells / cm ² / well in 24 wells using αMEM medium + 10% FBS as described above. After confluence, cells were induced to differentiate by adding ascorbic acid, β-glycerin phosphate, melatonin. For each condition, N = 3 was tested. Day 1 was considered as the day of cell seeding and induction followed cell confluence. Total induction time = 20 days. Four time points were sampled: Day 1, Day 2, Day 7, Day 10, Day 13, Day 20. Each time point had the following four groups: negative control, positive control, AMP treatment only, AMP + (w / induced). The AMP concentration used was 125 μg / ml.

  For the proliferation assay measured by the MTT assay, the culture period was 9 days for proliferation. Four time points were sampled: Day 1, Day 2, Day 4, and Day 9. Each time point had the following three groups: cells only, AMP only, AMP + cells. The AMP concentration used was 125 μg / ml.

Results Mineralization On day 1, cells were seeded for 24 hours and were not treated with induction medium or AMP (FIG. 76). The cells are circular and appear to be more raised on the monolayer. ARS staining showed a light beige color with little mineralization. On the second day, without induction, the negative control cells became hexagonal. ARS dyed the monolayer dirty and pale pink. Upon induction, positive control cells looked the same as negative controls with little mineralization and light ARS staining. Treatment with AMP changed MC3T3-E1 cell morphology and spindle shaped and spindle cells were observed. ARS staining showed an increase in mineralization from day 1 but the monolayer was stained pale pink. However, the area where the particulate matter of AMP settled was stained reddish brown. AMP treatment with induction also changed some cell morphology. Spindle-shaped cells were present, the monolayer was also stained pale pink, and the area around the AMP particulate was stained reddish brown. On day 7, negative control cells appear more hexagonal and the cell boundaries are more defined. Mineralization increased and the monolayer was dyed light beige. Positive controls developed spindle-shaped cells and spindle rings upon induction. ARS also stained a dark pink color as it mineralized. Treatment with AMP and AMP with induction precipitated AMP particulates and no cell morphology was seen. No cell monolayer of individual cells was seen. ARS showed that the area around the AMP particulate material was stained reddish brown and the monolayer was stained light pink. GnHCl succeeded in extracting the ARS dye, and the coefficient of variation of the OD ₄₅₀ value ranged from 6% to 16%.

Summary of Results Negative control MC3T3-E1 cells show increased ARS staining after 2 days and therefore mineralization with increased cell culture (FIG. 76). Similar to the previous results, positive control MC3T3-E1 cells cultured in induction medium undergo cell shape changes and develop spindle-shaped cells and spindle rings by day 7 (FIG. 76). ). After AMP treatment on day 1 (D2), changes in cell morphology were seen with or without induction. The cells became spindles and even fibroblasts were made (FIG. 76A). This change was not observed in negative or positive controls. Moreover, this change was observed in induced MC3T3-E1 cells after at least 4 days of culture (A in FIG. 76).

  AMP-treated and AMP-treated cells with induction showed a statistically significant increase in mineralization from the positive control by day 2 as shown by ARS quantification ( Fig. 76 B. The monolayer was stained light pink, but the small areas where the AMP particulates settled showed increased mineralization and stained dark reddish brown (A in Fig. 76). This increase in mineralization continued over the culture period.

  There was no increase in the promotion of mineralization by AMP when compared to AMP by induction treatment alone.

Proliferation To determine whether AMP promoted mineralization by promoting cell proliferation, MC3T3-E1 cells were cultured in αMEM medium + 10% FBS in 3 × 10 ⁴ cells / 96 in 96 wells. Seeding at cm ² / well. After confluence, the AMP group was treated with fresh 125 μg / ml AMP added every 3 days in the medium. The MTT assay was performed on days 1, 2 and 4 and the BrdU assay was performed on days 1, 2 and 16.

  In untreated MC3T3-E1 cells, cell viability increases from day 1 to day 4 (A in FIG. 77). In AMP-treated cells, cell viability decreased on day 2 and then more than doubled on day 4, according to the trend of the cell-only group. The BrdU assay showed a decrease in cell proliferation after day 1 in both the cell-only group and the AMP-treated cell group (FIG. 77B). Cell proliferation in the cell-only group decreased by more than half by day 2 and continued to decrease until day 16. In AMP treated cells, cell proliferation showed only a statistically significant decrease by day 16. These results suggest that AMP did not promote proliferation during the 16 day culture period.

Summary of Results Cell viability increased in MC3T3-E1 cells from day 1 to day 4 as shown by MTT assay. AMP-treated MC3T3-E1 cells showed a decrease in cell viability from day 1 to day 2, but continued to increase as did untreated cells. However, day 4 cell viability in AMP-treated cells was about half that of untreated MC3T3-E1 cells. Cell proliferation was reduced all the way from day 1 to day 16, as measured by BrdU. Unlike AMP-treated cells, cell proliferation was reduced by more than half by day 2 in untreated MC3T3-E1 cells. By day 16, AMP-treated and untreated MC3T3-E1 cells showed the same level of cell proliferation.

Example 42: Identification of genes expressed during the early stages of bone formation in AMP-treated MC3T3-E1 and hBM MSCs.
Human bone marrow mesenchymal stem cells (hBMMSCs) are pluripotent and can differentiate into multiple tissue types such as osteoblasts, chondrocytes, and adipocytes (Born, 2012 J Cell Biochem. 113 ( 1): 313-21.). When transplanted in vivo, they can form new bone, and in vitro hBM MSCs are obtained by culturing in β-glycerophosphate, ascorbic acid, vitamin D3, and low dose dexamethasone. Directed to formation. Osteogenesis for hBMMSCs is regulated by the expression of osteoblast-related genes, including specific transcription factors, adhesion molecules and proteins of ECM (Born (2012) J Cell Biochem. 113 (1): 313-21 Vater (2011) Acta Biomaterial. 7 (2): 463-77.). Progression to mature osteoblasts reflects the progression of MC3T3-E1 and occurs with loss of cell expansion capacity, increased expression of markers of bone formation, and mineralization of ECM (Born (2012) J Cell Biochem. 113 (1): 313-21). Initially, cells initiate ECM synthesis by expression of collagen I (Col I). At the same time, the expression of bone-specific alkaline phosphatase (bALP) increases and by day ⁴ observe a marked increase in ALP levels in cells induced from controls (6 × 10 ⁴ cells / 60 mm culture dish). (Born (2012) J Cell Biochem. 113 (1): 313-21; Jaiswal (1997) J Cell Biochem. 64: 295-312). As differentiation continues, cells produce proteins such as bone sialoprotein (BSP), osteopontin, osteonectin, and osteocalcin. Finally, mineralization of ECM shows mature osteoblasts, like bone formation in MC3T3-E1 cells.

  In this example, genes and transcription factors were expressed at an early stage of bone formation in three cell lines: MC3T3-E1 cells and hBM MSC cells were determined. Our results showed that a statistically significant increase in mineralization could be seen in AMP-treated MC3T3-E1 cells by day 2 (day 1 treatment) compared to the positive control showed that. Therefore, the experiment focused on the early stages of bone formation in order to identify the effects of AMP on specific genes after treatment.

Experimental Design MC3T3-E1 or human bone marrow MSC cells were seeded at 3 × 10 ⁴ cells / cm ² / well in 24-well plates using αMEM medium + 10% FBS as described above. Following confluence, cells were induced to differentiate by adding ascorbic acid and β-glycerin phosphate. N = 2 was tested for each assay at each time point. Four time points were sampled: Day 0 (after confluence but before induction / treatment), Day 1, Day 4, and Day 6. Each time point had three groups: negative control, positive control, AMP treatment only. The AMP concentration used was 125 μg / ml.

Results hMSC expression AMP induces strong endogenous expression of BMP2 and BMP6 transcripts (60-fold and 5-fold, respectively) within a 24-hour culture period (Figure 78A). BMP2 reached its peak at D1 (120 times) and remained at a high level (60-10 times) until day 4 before showing a decline. In contrast, BMP6 peaked at 4 hours and then gradually decreased from day 1. As a comparison, AMP did not change the expression levels of BMP4, BMP7 and BMP9. Nevertheless, AG induced a mild upregulation of BMP2 and BMP6 (1-2 fold) only on day 4 and a significant upregulation of BMP4 (4-10 fold) after day 1. As a comparison, AGM did not change the expression of either BMP7 or BMP9.

  Runx2 peaked on day 1 for AMP, but peaked on day 2 for AGM (FIG. 78A). Thereafter, both groups gradually declined and then reached another peak on day 6. Runx2 induces the differentiation of pluripotent mesenchymal cells into immature osteoblasts, thereby promoting the formation of immature bone. Moreover, Runx2 causes the expression of major bone matrix genes during the early stages of osteoblast differentiation, but Runx2 is not essential for the maintenance of these gene expression in mature osteoblasts (Komori (2010). ) Adv Exp Med Biol. 658: 43-9).

  Both ALP and Sox9 peak at day 4, and the level upregulated by AGM is lower than AMP (FIG. 78A). This trend is consistent in that ALP and Sox9 are downstream of Runx2. ALP is expressed in the early stages of bone formation and creates an alkaline environment that allows calcium to come out of solution and crystallize.

  AMP up-regulated VEGF peaked at 4 hours and 4 days, whereas AGM up-regulated VEGF only on day 4 (FIG. 78A). AMP upregulated CXCR4, while AGM upregulated SDF1 on day 1 with a rapid decline relative to the former, but a slower decline relative to the latter. It was. Kortesidis et al. ((2005) Blood. 105 (10): 3793-801) is required to proliferate and differentiate in response to environmental factors that may act to interfere with the SDF-1 / CXCR4 interaction. It suggests that SDF-1 may act to localize a population of early uncommitted BMSSCs within its perivascular niche. In MSC's seven preconditioning experiments, CXCR4 expression is usually about 2- to 4-fold increase (Cencioni et al. ((2012) Cardiovasc Res. 94 (3): 400-7), Our results showed a 60-fold increase after the first day.

  SDF-1 expression was very high in all groups of MSCs, but it appears not to be the case in FIG. 78A. SDF-1 was seen around cycle 20, while GAPDH was seen around cycle 17. From the literature it is known that stromal cell-derived factor-1 activates adhesion molecules on progenitor cells and mAb to SDF-1 inhibits transvascular endothelial migration of hematopoietic progenitor cells (Imai et al. (1999) Blood 93 (1): 149-56). SDF-1 activates CXCR4 + / CD34 + cells, leading to their adhesion and transvascular endothelial migration (Bhakta et al. (2006) Cardiovas Revac Med. 7: 19-24.). GAPDH expression increases in the AMP group from day 2 to day 6, and therefore growth is assumed. This trend was not seen in other samples. Furthermore, BMP9 was undetectable (after cycle 40), CXCR4 was detected around cycle 33, VEGF was detected around cycle 19, and SOX-9 was detected around cycle 27. BMP4 is detected around cycle 28, BMP7 is not detected (after cycle 40), BMP2 is detected around cycle 20, Runx2 is detected around cycle 25, BMP6 is detected around cycle 27, and ALPL is Detected around cycle 24.

MC3T3-E1 expression MSCs are known to be pluripotent and only lead to bone formation because bone precursors are already pushed down the lineage pathway. Unlike expected, BMP2 expression was barely expressed in mouse cells, especially compared to human MSC (FIG. 79). BMP has been shown to be ineffective in promoting osteogenesis in humans and cannot be said to be effective in mouse cells (Osyzka et al. (2004) Cells Tissues Organs. 176 (1-3): 109-19. Skarzynska et al. (2011) Connect Tissue Res. 52 (5): 408-14). BMP-2 expression is not prominent in MC3T3 cells as shown by the gene array (Beck et al. (2001) Cell Growth & Differentiation 12: 61-83). The differences seen between human cells and rodent cells may indicate that unlike Smad1 in human cells, rodent Smad1 does not undergo ERK linker phosphorylation during bone formation. Alternatively, Smad1 activity in rodent cells may not be suppressed by ERK-mediated linker phosphorylation (Skarzynska et al. (2011) Connect Tissue Res. 52 (5): 408-14). BMP-induced bone formation in poorly responsive human MSCs requires ERK regulation (inhibition) and the phosphatidylinositol 3-kinase (PI3-K) pathway; insulin / IGF-I activated PI3K / AKT pathway inhibition reduces BMP-induced alkaline phosphatase and osteopontin expression in serum-free cultures of human MSCs but increases Smads BMP activation (Osyzka et al. (2005) Endocrinology. 2005). (8): 3428-37).

  Runx2 was also shown to be different in MC3T3 cells compared to hMSC. Clearly there are cases of gene up-regulation in MC3T3 cells on day 2. The AGM group appears to have the opposite effect of the AMP group, which may be related to the Pi3K, MAPK pathway. Ibsp, also known as Bone Sialprotein (BSP), is upregulated in AMP on day 2 but is not expressed on other days. In the positive group, BSP is highly expressed after the second day.

  Bglap-rs1, also known as osteocalcin (OCN), is also upregulated in AMP on day 2, but is not expressed on other days. Consistent with BSP, OC is highly expressed in the positive group after 2 days. Through analysis of these results, BSP and OCN are known to be expressed by mature osteoblasts and may need to be up-regulated. Runx2 regulates the expression of Col1, BSP and OCN in MC3T3, which is consistent with our results. Runx2 increases on day 2 and is not expressed on other days, like BSP and OCN. In summary, AMP downregulates osteogenic gene expression but promotes mineralization.

Example 43: Effect of purified nHC-HA / PTX3 from AM on mineralization using MC3T3-E1 model system.
Previous experiments clearly demonstrated the unique properties of AMP that promote mineralization, independent of inducers such as ascorbic acid, β-glycerin phosphate, and melatonin (AGM). In these experiments, AMP was added to a murine osteoblast progenitor cell line (MC3T3) in the presence or absence of AGM to determine the efficacy of AMP. Alizarin red staining by the GnHCl extraction method was used at multiple time points for further quantification. It was concluded that AMP not only enhanced mineralization independent of AGM, but also enhanced mineralization at a faster rate. Further examination of AMP showed that the osteoinductive effect exhibited by AMP required direct cell contact. That is, under direct contact with AMP, cells will accelerate and enhance mineralization without the introduction of AGM.

  Previous studies have shown that induced MC3T3-E1 differentiation is in three stages: growth (Days 1-9), ECM formation (Days 9-16), and mineralization (Formation). (Mineral deposits in the ECM) (day 16+) have been shown to be subdivided (Quarles et al. (1992) J Bone Miner Res. 7 (6): 683-92 .; Hong et al. al. (2010) Exp Cell Res. 316 (14): 2291-300). However, our previous Aim 4 showed that mineralization can be easily detected within 7-10 days using AMP. Therefore, to determine whether nHC-HA / PTXS purified from AM is a factor that promotes mineralization, our ARS assay is performed on day 8. As seen in Aim 4, since the results are notable, day 8 is selected and the medium only needs to be replaced on days 0, 3 and 6.

  It is already known that nHC-HA / PTX3 is a factor in the known anti-inflammatory, anti-angiogenic and anti-scarring therapeutic effects of amniotic membrane. Assume that immobilized HC-HC / PTX3 is a factor in the effect on the promotion of AMP mineralization. Since it contains HA, nHC-HA / PTX3 is compared to HA to confirm that the putative effect is uniquely present in nHC-HA / PTX3 and not HA. Hyaluronan (HA) is a non-sulfated glycosaminoglycan consisting of a single repeating disaccharide unit. It is an important component in connective tissue that promotes matrix assembly and tissue hydration. Luben et al speculated that HA may act as a calcium-binding agent away from the resorption site, acting as a barrier to enzyme diffusion, or modulating osteoclast mobility. Stern and Raisz clarified that “hyaluronic acid appears to be most appropriate for the study because it is clearly associated with bone resorption”. Due to its hygroscopic nature, HA can occupy 10,000 times its own capacity. Thus, with HA, proliferating cells can avoid inhibitory contacts. Hyaluronic acid synthesis precedes mitosis and separates dividing cells from its substratum, allowing cell migration (Balazs (2001) Am J Physiological Integrated Physiol Comp 280: R466 * R472).

Experimental design:
Murine MC3T3-E1 cells (C-136) are removed from the liquid nitrogen freezer and up to 80% confluence to 1.5 × 10 ⁶ cells [4 ^* (3.1 ^× 10 ⁴ ) ^* 9 = 11,116,000 cells] Grow on 100 mm dishes (5 dishes) in αMEM medium (10 ml per 100 mm dish) + 10% FBS, changed daily. Cells were then plated plastic wells of 3.1 × 10 ⁴ cells / ^cm 2/96. Medium (100 ul per 96 wells) is changed every 2-3 days, ie, on day 0 (Wednesday), day 2 (Friday), and day 5 (Monday), and the culture is terminated on day 8 To do. N = 4 was tested according to the conditions.

The group summary was as follows:
Control group:
Negative control: None in conventional 96 well plates.
Positive control 1: AGM on conventional 96 well plate.
Positive control 2: 125 μg / ml AMP was added every 3 days on a conventional 96 well plate.
Experimental group:
Negative control: Covalink-NH 96-well plate Experimental group 1: Covalink-NH 96-well plate AGM was added every 3 days.
Experimental group 2: 20 μg / ml HA was immobilized on Covalink-NH 96 well plate.
Experimental group 3: 20 μg / ml HA was immobilized on Covalink-NH 96-well plates and AGM was added every 3 days (H-124).
Experimental group 4: 20 μg / ml nHC-HC / PTX3 was immobilized on Covalink-NH 96 well plate.
Experimental group 5:
20 μg / ml nHC-HC / PTX3 was immobilized on Covalink-NH 96 well plates and AGM was added every 3 days.

  For the AGM group: On days 0 and 3, the osteogenesis induction medium # 1 (ascorbic acid, β-glycerin phosphate) was replaced. On day 6, osteogenesis induction medium # 2 (ascorbic acid, β-glycerin phosphate, melatonin) was replaced. On day 0, only 0.2 ml of 10X induction medium was made. On days 3 and 6, fresh 10 ml osteogenesis induction medium was prepared. Instructions for induction medium were obtained from an in vitro bone formation assay kit (Millipore).

  Induction medium # 1: 9.88 ml αMEM medium + 10%, 20 μl ascorbic acid 2-phosphate 500X (Millipore, Part. 2004011), 100 μl glycerol 2-phosphate 100X (Millipore, Part. 2004011).

  Induction medium # 2: 9.87 ml αMEM medium + 10%, 20 μl ascorbic acid 2-phosphate 500X (Millipore, Part. 2004011), 100 μl glycerol 2-phosphate 100X (Millipore, Part. 2004011), 10 μl melatonin 50 uM (Millipore, Part. 2004011). 500 ul of dH20 is added to the supplied 6 ug melatonin.

  ARS staining and quantification was performed as described above. Pictures were taken at 10X using a Nikon Eclipse CFI60.

Results MC3T3-E1 cells were cultured on different well plates for 8 days. On day 8, a phase contrast photograph is taken from the well, which is seen below (FIGS. 79A, 79B). Negative control wells showed round cells and ARS stained very light pink. Wells with induction medium showed a much brighter red color and spindle cells were seen on the periphery of the well. ARS staining was more abundant in the outer peripheral rings. Treatment with AMP showed a deep red color after ARS treatment, and the cells were fairly difficult to confirm because AMP settled on them. No aggregation was observed during the experiment (although aggregation was seen on other cell types on immobilized HC-HA). Micrographs were taken on days 6, 7 and 8.

The extraction method of guanidine hydrochloride was used on day 8 and the well plate was incubated overnight. Although difficult to see with the naked eye, GnHCl was able to extract ARS dye; all wells appeared to have the same pale pink / red color. ARS extraction was quantified at 450 nm because the plate reader did not have the ability to read at or near 490 nm. The result can be seen in FIG. 79C. ^* Symbols indicate statistical significance of p <0.05. (+ Indicates having AGM, − indicates no AGM)

  Consistent with previous results, AMP successfully promoted mineralization without the need for inducers. Since this experiment lasted only 8 days, the results are not as remarkable as Aim 4, which lasted 20 days. All conditions treated with AGM showed increased mineralization from their negative control controls. Our results also show that immobilized nHC-HA / PTXS is not a factor that promotes mineralization at AMP. Therefore, there should be another active component of AMP that promotes mineralization.

Example 44: Effect of HC-HA / PTX3 (PBS) and HC-HA / PTX3 (Gn) on endochondral ossification Major transcription factors (Runx2 and Sox9, respectively) on bone formation and cartilage formation It was expressed by cells under both HC-HA conditions over the culture period. HC-HA / PTX3, both soluble and insoluble, can promote BMP2 expression and to the extent of BMP6 without osteoinductive drugs, AGM (ie, ascorbic acid, glycerin phosphate, melatonin) Are available commercially (see below).

  Chondrogenic marker Collagen 2 was highly expressed by HC-HA / PTX3 (PBS) without the need for AGM. HC-HA / PTX3 (Gn) plus AGM was also able to upregulate collagen 2. Osteogenic markers (BSP, ALPL, Osx) were upregulated by HC-HA conditions on day 14, thus confirming the transition from cartilage to bone genotype.

Experimental design:
Culture conditions: Human bone marrow-derived mesenchymal stem cells purchased from Lonza (Basel, Switzerland) were removed from a liquid nitrogen freezer and placed on a 100 mm dish in the same medium changed every 3 days to 80% confluence. Grown up. The cell culture medium was αMEM containing 10% fetal bovine serum and antibiotics. The culture medium (10 ml per 100 mm dish) was changed every 3 days and the cells were subpassaged at 80% confluence until the desired cell count was reached. For experiments, cells were immobilized with or without osteoinductive drugs, ascorbic acid 2-phosphate, glycerol 2-phosphate and melatonin (AGM), HA, HC-HA (PBS). Alternatively, seeded at 3.1 × 10 ⁴ cells / 96 plastic wells on HC-HA (Gn). The final concentrations of AGM added were 0.2 mM, 10 mM and 50 nM, respectively. When the cells were seeded (day 0), AGM was added simultaneously and mRNA was extracted on days 1, 7 and 14. QPCR was performed to quantify gene expression. The medium (100 ul per 96 well) was changed every 3 days.

The outline of the experimental group was as follows:
Negative control: Covalink-NH 96-well plate Experimental group 1: Covalink-NH 96-well plate AGM was added every 3 days.
Experimental group 2: 20 μg / ml HA was immobilized on Covalink-NH 96 well plate.
Experimental group 3: 20 μg / ml HA was immobilized on Covalink-NH 96 well plate and AGM was added every 3 days.
Experimental group 4: 20 μg / ml of 4 × nHC-HC / PTX3 was immobilized on Covalink-NH 96 well plate.
Experimental group 5: 20 μg / ml of 4 × nHC-HC / PTX3 was immobilized on Covalink-NH 96 well plate and AGM was added every 3 days.
Experimental group 6: 20 μg / ml of 4 × nHC-HC / PTX3 (GuHCl extraction) was immobilized on a Covalink-NH 96-well plate.
Experimental group 7: 20 μg / ml of 4 × nHC-HC / PTX3 (GuHCl extraction) was immobilized on Covalink-NH 96 well plate and AGM was added every 3 days.

  Regarding the AGM induction group: On days 0 and 3, the osteogenesis induction medium # 1 (ascorbic acid, glycerin phosphate) was replaced. On day 6, the osteogenesis induction medium # 2 (ascorbic acid, glycerin phosphate, melatonin) is replaced. On day 0, 10X induction medium was made. On days 3 and 6, fresh 10 ml osteogenesis induction medium was prepared. Instructions for preparation of induction medium were obtained from an in vitro osteogenesis assay kit (Millipore).

  Induction medium # 1: 9.88 ml αMEM medium + 10%, 20 μl ascorbic acid 2-phosphate 500X (Millipore, Part. 2004011), 100 μl glycerol 2-phosphate 100X (Millipore, Part. 2004011)

  Induction medium # 2: 9.87 ml αMEM medium + 10%, 20 μl ascorbic acid 2-phosphate 500X (Millipore, Part. 2004011), 100 μl glycerol 2-phosphate 100X (Millipore, Part. 2004011), 10 μl melatonin 50 uM (Millipore, Part. 2004011). 500 ul of dH20 is added to the supplied 6 ug melatonin.

mRNA was extracted from the cells on days 1, 7 and 14 and gene expression was determined by QPCR (FIGS. 80A-E). The following genes were assayed: bone formation marker Runx2, alkaline phosphatase (ALPL), marker collagen 1 (COL1), Osterix (OSX) and bone sialoprotein (BSP) and chondrogenesis markers Sox9 and collagen 2 (COL2), hypertrophy Sex markers, collagen 10 (COL10) and MMP13.
ARS staining and quantification was performed on day 14 cultures as described above (FIGS. 81A, 81B).

  AGM up-regulated BMP4 on plastic. HA up-regulated BMP4 (early), but down-regulated BMP6 (late) and did not affect BMP2 (FIG. 80B). Literature data does not suggest that HA itself up-regulates BMP. However, the addition of AGM up-regulated BMP2 and BMP6.

  4X soluble HC-HA initially up-regulated BMP4 but later down-regulated BMP4 (like HA) and significantly up-regulated BMP2 (like AMP but transiently) (Without BMP6) (FIG. 80B). In contrast, the addition of AGM did not change the expression pattern of BMP. 4X soluble HC-HA initially upregulated BMP4, but downregulated BMP4 (later) (like HA) and significantly upregulated BMP2 (like soluble HCHA). (FIG. 80B). [Consistent with solubility] Similarly, the addition of AGM did not change the expression pattern.

  Our results indicate that soluble and insoluble HC-HA were able to form bone differentiation and mineralization by mechanisms within the cartilage. The expression of bone markers (Col1, Osx, ALP, and BSP) was evident as was the expression of cartilage markers (Col2) and hypertrophic markers (Col10, MMP13) (FIGS. 80A-E). The difference between these HC-HA conditions is that soluble HC-HA can promote greater amplitude of gene expression and more pronounced bone nodules (even without AGM), but insoluble HC-HA. Requires AGM (data not shown). Thus, HC-HA / PTX3, both soluble and insoluble, was able to promote the expression of BMP2 without the osteoinductive agent AGM.

  HA without AGM also showed a chondrogenic marker (COL2) but showed signs of bone formation due to mineralization as defined by ARS, and a slight increase in ALP and OC. However, HC-HA / PTX3 (PBS) had greater chondrogenic and higher expression of bone markers ALP, Osx and BSP than HA. However, none of these conditions expressed significant hypertrophic markers. HC-HA / PTX3 (Gn) expressed much greater expression of ALP, OSX and BSP than the two previous conditions. The hypertrophic marker MMP13 was also expressed, as was the slight expression of the chondrogenic marker COL2.

  HA + AGM promotes bone formation with increased expression of BMP2, ALP, Osx, BSP and OC, indicating hypertrophic markers COL10 and MMP13. However, HA did not produce as much bone-specific mRNA expression and bone nodule formation as the HC-HA group. Another important difference was that HA down-regulated SOX9 but later increased BMP6 expression.

  All previous data indicate that insoluble HC-HA is the most potent inducer of bone and more importantly induces mechanisms in the cartilage.

Example 45. nHC-HA / PTX3 suppresses inflammatory and immune responses and improves murine cornea allograft survival.
Experimental and clinical studies have shown that amnion (AM), AM extract, and nHC-HA / PTX3 [inter-α-trypsin inhibitor (IαI) and hyaluronan (HA) heavy chain (HC) formed The conjugated complex] has been shown to suppress pro-inflammatory reactions. This example demonstrates that nHC-HA / PTX3 / PTX3 can modulate T cell responses and reduce murine corneal allograft rejection.

  T cell activation can be assessed by proliferation and production of various cytokines (FIG. 82). In this example, splenocytes were isolated from OT-II mice expressing a transgenic TCR specific for ovalbumin (OVA) and stimulated with OVA for up to 4 days (FIG. 83). Cell proliferation was measured by BrdU labeling and cytokine (IFNg and IL-2) expression was measured by each ELISA. NHC-HA / PTX3, but not HA at 1 mg / ml, grew IFN-γ and IL-2 (FIG. 85) in splenocytes with OVA peptide on days 2 and 4 (FIG. 84). ) And production was significantly suppressed (all p <0.05). In addition, corneal T cells were activated in vivo by LPS injection.

  Optimization of the site, amount and frequency of injection with nHC-HA / PTX3 prior to or during intracorneal injection of LPS was determined by influx of EGFP positive macrophages into the cornea of Mafia mice. The injection regimen was further optimized by giving 5 μl for each injection between the subconjunctiva and the fornix for all four quadrants. On the fourth day after nHC-HA / PTX3 treatment, the cornea was digested with 820 units / ml collagenase for 1 hour at 37 ° C. EGFP- and EGFP + cells were isolated by FACS. Pretreatment of nHC-HA / PTX3 3 days prior to LPS infusion significantly suppressed EGFP + macrophage influx into the LPS-invasive cornea (9.1 ± 0.3 vs 12.3 ± 0.4, nHC-HA / PTX3 vs. PBS, p = 0.02) (FIG. 86). Importantly, even though EGFP + macrophages are translocated to the cornea, some of them are markedly upregulated in Arg-1 and IL-10 but down in IL-12 (p <0.05) Polarization towards the M2 phenotype, as suggested by regulation (Figure 87). Arg-1, IL-10 and IL-12 mRNA expression was measured by qPCR. Finally, allogeneic corneal transplants were performed using wild-type BALB / c mice as recipients and C57BL / 6 mice as donors, the results of which were scored by graft clarity. Was measured twice a week using a slit lamp biomicroscopy. Grafts that received two consecutive scores ≧ 3 without degradation were considered rejected. Compared to the PBS control, allograft rejection was markedly suppressed (p <0.05) once a week with an injection of 10 μl nHC-HA / PTX3, one quadrant, 2 weeks Times, four quadrants were further reduced by injection with 5 μl (p <0.002) (FIG. 88).

  These experiments demonstrate that nHC-HA / PTX3 significantly suppresses murine cornea allograft rejection. This mechanism of action may contribute to the ability of nHC-HA / PTX3 to down-regulate pro-inflammatory macrophages and suppress T cell immune responses.

Example 46: Treatment of mouse eye dryness caused by desiccating stress with nHC-HA / PTX3 and AMP Eye dryness, also known as dysfunctional tear syndrome, is a worldwide prevalence It is a common ocular surface disease with significant mortality. It is an autoimmune-based inflammatory disease characterized by inertial self-reactive T cell-mediated inflammation and dysfunction of the tear function unit (LFU; cornea, conjunctiva, lacrimal gland, and meibomian gland) . Sjogren's syndrome (SS) is a chronic autoimmune disease characterized by infiltration of saliva and lacrimal glands by mononuclear cells, causing secondary damage to the parenchyma.

  Dry keratoconjunctivitis (KCS) in SS is a severe and potentially vision- threatening epithelial disease of the eye characterized by infiltrating CD4 + T cells that produce IL-17 and interferon (IFN) -γ It is. Compounds that inhibit T cell activation (eg, cyclosporin A) attenuate dry eye disease in both animals and humans. Macrophages undergo typical M1 activation (eg, by IFN-γ and / or TLR ligands such as LPS), resulting in high levels of pro-inflammatory cytokines (such as TNF-α, IL-12, and IL23). ), Which activates Th1 and Th17 lymphocytes (FIG. 89), leading to many chronic inflammatory diseases. This example demonstrates that administration of nHC-HA / PTX3 and AMP can be useful in the treatment of such diseases.

  Macrophage infiltration into the cornea is inhibited at four injection sites for each eye.

  MAFIA mice, when labeled with EGFP, allow in vivo tracking of macrophage influx. These mice were used (model for keratitis) to determine if nHC-HA / PTX3 or AMP prevents LPS-induced macrophage influx to the cornea. LPS was injected into each injection site in an appropriate volume of 5 μl or less between the subconjunctiva and the fornix. LPS (5 μg per eye) was injected intramatrix into the eyes of MAFIA mice (macrophages are EGFP +). In each eye, OS is treated with PBS (2 or 4 injection sites), while OD is treated with nHC-HA / PTX3 (2 or 4 injection sites; nHC-HA / PTX3 per injection site). One treatment with either 1 mg / ml HA in, 5 μl) or AMP (2 or 4 injection sites; 10 mg protein in AMP per injection site, 5 μl). The treatment was immediately after LPS injection. Overall corneal images were taken by in vivo in vivo microscopy on days 1, 2, 3 and 6. EGFP positive cells were counted because they were based on the intensity of green fluorescence.

  On day 1, EGFP positive macrophages are detected in most peripheral areas of the cornea after LPS injection with PBS treatment. Treatment with either nHC-HA / PTX3 or AMP did not significantly increase or decrease macrophages in the cornea.

  On day 2, macrophages in the cornea with PBS treatment increased significantly from day 1 (p <0.05), indicating that nHC-HA / PTX3 (2 and 4 injection sites, p <0 .05), and treatment with AMP (2 and 4 injection sites, p <0.05). Specifically, more macrophages were infiltrated in the cornea treated by two injections of nHC-HA / PTX3 than PBS treatment (p> 0.05), but nHC-HA / PTX3 ( Less in the cornea treated by 4 injections with p> 0.05). With respect to AMP treatment, the two injections had no significant effect, but the four injections slightly reduced macrophage infiltration, which was four times for either nHC-HA / PTX3 or AMP for each eye. This suggests that the injection of is necessary for its effect on reducing macrophage infiltration.

  On day 3, macrophage infiltration was continued by treatment with PBS, nHC-HA / PTX3, and AMP.

  There was no inhibition of invasion by treatment with 2 injections of nHC-HA / PTX3, 4 injections, or 2 injections of AMP. Only treatment with 4 injections of AMP (p <0.05) has been shown to lead to inhibition.

  On day 6, macrophage infiltration decreased. However, HC-HA / PTX3 or AMP treatment had no significant inhibitory effect compared to controls.

  These data show that EGFP-positive macrophages continue to infiltrate the cornea infused with LPS from day 1 to day 3, peaking on day 4 or 5 and then decreasing on day 6 showed that. This is consistent with the previously reported data (Figure 90). Macrophage infiltration was slightly inhibited by treatment with 4 injections of nHC-HA / PTX3 per eye on day 2 or by treatment with 4 injections of AMP on days 2 and 3. It was. This suggests that AMP has a better efficacy than nHC-HA / PTX3 in blocking the influx of macrophages elicited by LPS.

  Pretreatment with AMP significantly inhibits macrophage infiltration stimulated by damage caused by additional infusions, if followed by infusion of either nHC-HA / PTX3 or AMP.

  The left eye (OS) of each MAFIA mouse was pre-treated with PBS (5 μl) or AMP (10 mg / ml protein, 5 μl) at four sites, subconjunctival / annulus, as defined above. The right eye (OD) of each mouse remained untreated. Three days later, each eye was infused with LPS (5 μg) into the cornea and immediately at 4 sites PBS (5 μl), HC-HA / PTX3 (1 mg / ml HA, 5 μl), or AMP ( Treatment with 10 mg / ml protein, 5 μl) followed. EGFP + macrophage infiltration was counted using in vivo in vivo microscopy, which did not disclose the significance (P> 0.05) of reducing macrophage influx to the mouse cornea (data not shown) Not) The accuracy of this quantitative method was then investigated by in vivo fluorescence microscopy.

  To more accurately measure infiltrated macrophages and to examine the resulting macrophage phenotype (eg, M1 vs. M2), the cornea removed on day 4 was exposed to collagenase digestion and FACS to allow EGFP positive It was decided to quantify macrophages. Subsequently, EGFP positive macrophages were normalized by EGFP negative cells as a ratio to assess the extent of macrophage infiltration. In the group without pretreatment, LPS infusion resulted in macrophage infiltration in the PBS control group (FIG. 91, A, blue bar). This invasion is observed in nHC-HA / PTX3 (9.1 ± 0.3 vs 12.3 ± 0.4, p = 0.02) or AMP (2.1 ± 0.1 vs 12.3 ± 0.4). P = 0.02). AMP treatment was superior to nHC-HA / PTX3 treatment in inhibiting macrophage infiltration (p = 0.02).

  In the group with pretreatment, LPS infusion caused significant macrophage infiltration in the PBS control group compared to no pretreatment (37.2 ± 1.3 vs 12.3 ± 0.4, p = 0). .01) (FIG. 91, A, red bar). This difference was expected because the four subconjunctival injections made during pretreatment caused inflammation-induced damage that increased macrophage influx to the cornea that was later treated with LPS. Nevertheless, this dramatic increased infiltration is followed by nHC-HA / PTX3 (8.2 ± 0.3 vs 37.2 ± 1.3, p = 0.02) following pretreatment with AMP. Or completely inhibited by either AMP treatment (2.3 ± 0.1 vs 37.2 ± 1.3, p = 0.02). Again, AMP treatment following AMP pretreatment was superior to inhibiting macrophage infiltration (2.3 ± 0.1 vs. 8.2 ±) over nHC-HA / PTX3 treatment following AMP pretreatment. 0.3, p = 0.02). However, for nHC-HA / PTX3 or AMP (p> 0.05), there was no significant difference in inhibition between groups with and without AMP pretreatment. The qPCR data (FIG. 91, B) show that nHC-HA / PTX3 pretreatment decreased the M1 marker in the case of IL-12p40 and IL-12p35 while increasing the M2 marker in Arg-1. Is shown. Treatment with AMP and pretreatment significantly reduce IL-12p40 and IL-12p35, but greatly increase arginine-1 and IL-10. In all, pretreatment with AMP can completely eliminate macrophage infiltration stimulated by further damage during pretreatment. Such effects are retained by subsequent injections of either nHC-HA / PTX3 or AMP simultaneously with LPS injection. This advantage is noticeable after 4 days and AMP is more potent than nHC-HA / PTX3.

  nHC-HA / PTX3 or AMP can reduce DS-induced ALKC in a murine experimental dry eye model.

Design Species: C57BL / 6 mouse End point: Epithelial barrier function of cornea (OGD staining)
Sample size: 15 mice per group Group: 2 control groups and 3 treatment groups (PBS, nHC-HA / PTX3, and AMP): 1) Non-eye dry, untreated control (UT)-separate 2) Experimental dry eye, untreated control (EDE); 3) PBS; 4) nHA-HC / PTX; 5) AMP.

Drying stress (D)
A model of drought stress is created by exposure to pharmacological cholinergic blockade of lacrimation and air ventilation and low humidity in an environmentally controlled room for 5 days (Monday-Friday). The mouse is placed in a specially designed perforated cage consisting of a generic mouse cage with sides interchanged with a wire mesh that allows airflow through the cage. Each cage is placed in front of a constant air flow (electric fan). Lacrimal secretion is inhibited by subcutaneous administration of scopolamine (0.5 mg in 0.2 mL, Sigma-Aldrich) 4 times a day for 5 days (8:30 am, 11:30 am, 1:30 pm, 4:30 pm) . The humidity of the environmentally controlled room is maintained at ˜25-30% relative humidity, which is achieved by four portable dehumidifiers and one dehumidifier unit on the ceiling.

Treatment procedure (5 day protocol)
Three controls are included in each experiment:
Untreated controls consist of a group of mice kept in an animal facility under 40-70% relative humidity.
These mice are never exposed to DS or receive topical treatment.
The dry eye control consists of a group of mice that are placed in an environmental dry eye chamber but not treated.
The vehicle control consists of a group of mice exposed to DS but receiving PBS.
In addition, two experimental groups are included: nHA-HC / PTX3 and AMP

  For injection, nHC-HA / PTX3 (containing 1 mg / ml HMW HA) and AMP (containing 10 mg / ml total protein) were used with PBS as a vehicle control. All solutions (PBS, nHC-HA / PTX3, and AMP) were drawn into a tuberculin syringe with 30G. The injection position is under the conjunctiva near the dome (FIG. 92). Four (4) injections were performed at 5 μl per injection site at 3, 6, 9, and 12 hours. The diffused solution completely covers the entire periphery of the conjunctiva, with minimal conjunctival or ocular hyperemia / swelling that should prevent eye closure, corneal surface damage or inflammation (if any, it should disappear in 15 minutes) Caused. Injections were made a total of 2 times on days 1 and 3 (for all reagents). This infusion protocol is summarized in Table 6.

Measurement of Corneal Staining On the morning of the fifth day, the mice received a single S. pylori scopolamine after tear volume measurement. C. Received the dose. Two hours after scopolamine administration, corneal staining was performed using Oregon Green Dextran (OGD-488), a fluorescent dye coupled with a molecular size of 70 kDa (Molecular Probes). The procedure consisted of a drop of 0.5 μl OGD on the cornea using a glass capillary pipette 1 minute before euthanasia. Mice were euthanized by cervical dislocation followed by aspiration of isoflurane anesthetic gas. Thereafter, the eyes were washed away with 2 ml of BSS. Excess liquid was blotted off carefully from the ocular surface with filter paper without touching the cornea. Binocular digital images were captured under an excitation wavelength of 470 nm and an emission wavelength of 488 nm using a Nikon SMZ-1500 stereo microscope with a CoolSnap HQ2 cooled CCD camera during an exposure time of 1 second. Both eyes from each animal were evaluated. The fluorescence intensity of a fixed area of constant interest (1 mm diameter circle) in the central cornea was measured in 3 digital images using Nikon Elements software and the data was stored in a database (Excel, Microsoft). The The results were expressed as the mean of gray scale ± standard deviation. Results from 3 separate experiments were averaged for statistical comparison of groups.

  Comparison of the effects of nHC-HA / PTX3 and lyophilized amniotic powder (AMP) on the level of mediators in the helper T cell pathway in an experimental dry eye (EDE) model created in C57BL / 6 mice for 5 days did. Th1 (IL-12, IFN-γ, and T-Bet), Th-17 (IL-23, IL-17, ROR-γt, IL-6, TGF-β1, MMP-3 and MMP-9), and Expression of factors related to Th2 (IL-4, IL-13 and GATA3) was measured in corneal epithelium and conjunctiva in the following groups by real-time PCR.

Statistical analysis.
Statistical analysis was performed using GraphPad Prism 5.0 software (GraphPad Inc). One-way analysis of variance (ANOVA) was used to determine overall differences between groups followed by a post-hoc test (Tukey's post hoc). Unpaired t-test is used to assess statistical differences between the two experimental groups.

Example 47:
HC-HA activates IGF1-HIF1α-VEGF signaling to promote angiogenesis, which is further facilitated by the addition of TGFβ1 in human corneal fibroblasts.

  In this example, the effect of the HC-HA complex on the induction of angiogenic markers in human corneal fibroblasts was examined.

  Human corneal fibroblasts (3000 cells / well in a 96-well plate) were immobilized on 48 hours of immobilized HA, soluble HC-HA (PBS) (4X) or insoluble HC as described above. -Seeded on plastic dishes with or without HA (GnHCl) (4X) or without HA. Cells were then treated with or without TGFβ1 for 24 hours before harvesting for IGF1, HIF1α and VEGF mRNA quantification. The experiment was as follows:

  Total RNA was extracted using RNeasy Mini Kit (Qiagen) and reverse transcribed using High Capacity Reverse Transfer Kit (Applied Biosystems). The cDNA of each cell component was amplified by real-time RT-PCR using a specific primer probe mixture and DNA polymerase in a 7000 Real-time PCR System (Applied Biosystems). The real-time RT-PCR profile consisted of initial activation at 95 ° C. for 10 minutes, followed by 40 cycles of 15 seconds denaturation at 95 ° C., and 1 minute annealing and extension at 60 ° C. The identity of each PCR product (IGF1, HIF1α and VEGF) was determined according to the EC3 Imaging System (BioImaging System) using a 2% agarose gel and by ethidium bromide staining with subsequent PCR markers. Was confirmed.

  When the cells were quiescent, HC-HA induced a 2-6 fold increase in IGF1 mRNA and a 2 fold increase in VEGF mRNA (FIG. 92). In contrast, when cells were challenged with TGFβ (10 ng / ml), HC-HA induced a 5-12 fold increase in IGF1 mRNA and a 5-9 fold increase in VEGF mRNA. VEGF has been demonstrated to be a major factor in angiogenesis, which increases the number of capillaries in a given network. VEGF activation is controlled by upstream regulators such as IGF1 and HIF1α. Our results demonstrate that HC-HA activates the IGF1-HIF1α-VEGF network to promote angiogenesis, which is due to the addition of TGFβ1 in human corneal fibroblasts. Further promoted.

  While preferred embodiments have been shown and described herein, it will be apparent to those skilled in the art that such embodiments are provided by way of example only. Numerous changes, changes and substitutions can occur here. It should be understood that various alternatives to the embodiments described herein can be utilized in performing the described methods. The following claims are intended to define the scope of the embodiments, and methods and structures within the scope of these claims and their equivalents are intended to be encompassed thereby.

Claims (148)

A method for generating a reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex in vitro, comprising:
In order to form an immobilized rcHC-HA / PTX3 complex, (i) high molecular weight hyaluronan (HMW HA) immobilized on a solid support, (ii) pentraxin 3 (PTX3) protein, (iii) heavy chain 1 Contacting an inter-alpha inhibitor (IαI) protein comprising (HC1) and (iv) gene 6 (TSG-6) stimulated with tumor necrosis factor alpha. (A) In order to form an immobilized complex of PTX3 and HMW HA (immobilized PTX3 / HA), (i) high molecular weight hyaluronan (HMW HA) immobilized on a solid support, and (ii) Contacting the pentraxin 3 (PTX3) protein; and
(B) Inter-alpha inhibitor (IαI) protein containing heavy chain 1 (HC1) and gene 6 stimulated with tumor necrosis factor α (TSG-6) to form an immobilized rcHC-HA / PTX3 complex And contacting with the immobilized PTX3 / HA. (A) In order to form an rcHC-HA complex pre-bound to TSG-6, (i) high molecular weight hyaluronan (HMW HA) immobilized on a solid support, (ii) heavy chain 1 (HC1) An inter-alpha inhibitor (IαI) protein comprising, and (iii) contacting TSG-6; and
2. The method of claim 1, comprising contacting the rcHC-HA complex pre-bound to TSG-6 with a pentraxin 3 (PTX3) protein to form (b) an rcHC-HA / PTX3 complex. .   4. A method according to any one of claims 1 to 3, wherein TSG-6 catalyzes the covalent binding of IαI HC1 with HA.   3. The method of claim 2, further comprising removing unbound PTX3 protein after step (a) and before performing step (b).   The method according to any of claims 2 to 5, further comprising the step of removing unbound TSG-6 after step (b).   The method according to any one of claims 1 to 6, wherein the PTX3 protein is a natural PTX3 protein or a recombinant PTX3 protein, and the TSG-6 protein is a natural TSG-6 protein or a recombinant TSG-6 protein. .   The method according to any one of claims 1 to 7, wherein the IαI protein further comprises HC2, bikunin, chondroitin sulfate chain, or a combination thereof.   The method according to any of claims 1 to 8, wherein the IαI protein is isolated from blood, plasma, serum, amniotic membrane, chorion, amniotic fluid, or a combination thereof.   The method according to claims 7 to 9, wherein the IαI protein, the natural TSG-6 protein, and / or the natural PTX3 protein are produced from amniotic cells.   11. The method of claim 10, wherein the amniotic cells are amniotic epithelial cells, umbilical cord epithelial cells, amniotic stromal cells, or umbilical cord stromal cells.   The method according to claim 1, wherein the PTX3 protein is a homomultimer.   13. The method of claim 12, wherein the PTX3 homomultimer is an octamer.   14. A method according to any of claims 1 to 13, wherein PTX3 comprises a modified multimerization domain or a heterologous multimerization domain.   15. The method according to any of claims 1 to 14, wherein the PTX3, IαI HC1, or TSG-6 polypeptide comprises an affinity tag.   16. The method of claim 15, wherein the affinity tag is selected from a hemagglutinin tag, a poly-histidine tag, a myc tag, a FLAG tag, and a glutathione-S-transferase (GST) tag.   The method according to any one of claims 1 to 16, wherein the protein of IαI and TSG-6 are contacted at a molar ratio of 3: 1.   The method according to any one of claims 1 to 17, wherein the weight average molecular weight of HMW HA is 3,000 kDa.   The method according to claim 1, wherein the HMW HA is fixed to the solid support by direct bonding.   The method according to claim 1, wherein the HMW HA is fixed to the solid support by indirect bonding.   The method according to any one of claims 1 to 18, wherein the HMW HA is immobilized by binding to a solid support through a cleavable linker.   24. The method of claim 21, wherein the cleavable linker is a chemically or enzymatically cleavable linker.   The method according to claim 1, wherein the HMW HA is immobilized on a solid support by a covalent bond or a non-covalent bond.   The method according to any one of claims 1 to 18, wherein the HMW HA is immobilized by binding the HMW HA to an intermediate polypeptide.   25. The method of claim 24, wherein the intermediate polypeptide is covalently bound to a solid support.   26. The method of claim 24 or 25, wherein the HMW HA is bound to the intermediate polypeptide by non-covalent bonds.   27. A method according to any of claims 24 to 26, wherein the intermediate polypeptide is an HA binding protein (HABP).   HABP is HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, brevican, phosphacan, TSG-6, CD44, stabilin-1, stabilin-2, or some of these sufficient to bind to HA 28. The method of claim 27, wherein the method is selected from:   28. The method of claim 27, wherein the HABP is versican.   30. A method according to any of claims 24 to 29, wherein the intermediate polypeptide comprises a link module.   31. The method of claim 30, wherein the link module is a link module of HAPLN1, HAPLN2, HAPLN3, HAPLN4, aggrecan, versican, neurocan, brevican, phosphacan, TSG-6, CD44, stabilin-1, or stabilin-2. .   32. A method according to any of claims 24 to 31, wherein the intermediate polypeptide comprises a polypeptide linker.   35. The method of claim 32, wherein the polypeptide linker is attached to a solid support.   34. A method according to any of claims 24 to 33, wherein the intermediate polypeptide comprises a protein cleavage sequence.   The method according to any one of claims 1 to 22, further comprising the step of dissociating the immobilized rcHC-HA / PTX3 complex to form a dissociated rcHC-HA / PTX3 complex.   36. The method of claim 35, wherein dissociation from the immobilized rcHC-HA / PTX3 complex comprises cleavage of the cleavage linker.   36. The method of claim 35, wherein dissociation of the immobilized rcHC-HA / PTX3 complex comprises contacting the complex with a dissociator.   38. The method of claim 37, wherein the dissociator is guanidine hydrochloride or urea.   39. A method according to any of claims 35 to 38, further comprising purifying the dissociated rcHC-HA / PTX3 complex.   40. The method of claim 39, wherein the purification comprises affinity purification, centrifugation, filtration, chromatography, or a combination thereof.   41. The method according to any of claims 1 to 40, further comprising contacting the immobilized PTX3 / HA complex or rcHC-HA / PTX3 complex with a small leucine rich proteoglycan (SLRP).   The SLRP is selected from among decorin, biglycan, fibrojuline, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, osteoadherin, epipican, and osteoglycine. The method described in 1.   42. The method of claim 41, wherein the SLRP is selected from decorin, biglycan, and osteoglycine.   44. The method of any one of claims 41 to 43, wherein SLRP is covalently bound to a glycosaminoglycan.   45. The method of claim 44, wherein the glycosaminoglycan is keratan sulfate.   46. A reconstituted HC-HA / PTX3 (rcHC-HA / PTX3) complex produced by the method of claims 1-45.   Reconstituted HC− comprising high molecular weight hyaluronan (HMW HA), (ii) pentraxin 3 (PTX3) protein, and (iii) inter alpha inhibitor (IαI) protein comprising heavy chain 1 (HC1) HA / PTX3 (rcHC-HA / PTX3) complex.   48. The rcHC-HA / PTX3 of claim 47 fixed to a solid support.   Isolated natural HC-HA / PTX3 (nHC-HA / PTX3) complex purified from amnion extract or umbilical cord extract.   50. The isolated natural nHC-HA / PTX3 complex of claim 49, wherein the amniotic membrane extract or umbilical cord extract is prepared from amniotic membrane, umbilical cord amniotic membrane, umbilical cord stroma, or a combination thereof.   51. The isolated native nHC-HA / PTX3 complex of claim 49 or 50, wherein the nHC-HA / PTX3 complex is purified by ultracentrifugation of an amniotic membrane extract or umbilical cord extract.   52. The isolated natural nHC-HA / PTX3 complex of claim 51, wherein the amniotic membrane extract or umbilical cord extract is a water-insoluble extract.   53. The isolated natural nHC-HA / PTX3 complex of claim 52, wherein the non-water soluble extract is extracted with guanidine hydrochloride.   54. The isolated natural nHC-HA / PTX3 complex of any of claims 51 to 53, further comprising a small leucine-rich proteoglycan (SLRP).   55. The SLRP is selected from among decorin, biglycan, fibromodulin, lumican, PRELP (leucine-rich protein with proline arginine-rich termini), keratocan, osteoadherin, epipican, and osteoglycine. Isolated natural nHC-HA / PTX3 complex.   55. The isolated natural nHC-HA / PTX3 complex of claim 54, wherein the SLRP is selected from among decorin, biglycan, and osteoglycine.   57. The isolated natural nHC-HA / PTX3 complex of any of claims 54 to 56, wherein SLRP is covalently linked to a glycosaminoglycan.   58. The isolated natural nHC-HA / PTX3 complex of claim 57, wherein the glycosaminoglycan is keratan sulfate.   52. The isolated natural nHC-HA / PTX3 complex according to any of claims 49 to 51, wherein the amniotic membrane extract or umbilical cord extract is a water-soluble extract.   60. The isolated natural nHC-HA / PTX3 complex of claim 59, wherein the water soluble extract is extracted with an isotonic salt solution.   61. The isolated natural nHC-HA / PTX3 complex of claim 60, wherein the isotonic salt solution is PBS.   63. The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-HA / according to any of claims 49 to 61, wherein the complex promotes M2 polarization of macrophages. PTX3 complex. (I) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex decreases expression of IL-12p40 in macrophages stimulated with LPS and is expressed by macrophages stimulated with LPS IL-12p40 values were compared to those of IL-12p40 expressed by macrophages stimulated with LPS in the absence of rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complexes. Lower when rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex is contacted with macrophages stimulated with
(Ii) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex reduces expression of IL-12p70 protein in LPS-stimulated macrophages and is expressed by LPS-stimulated macrophages The amount of IL-12p70 protein expressed was compared to the amount of IL-12p70 protein expressed by macrophages stimulated with LPS in the absence of rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex Then, when rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex was contacted with macrophages stimulated with LPS,
(Iii) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex decreases expression of IL-23 in macrophages stimulated with LPS and is expressed by macrophages stimulated with LPS IL-23 values were compared to those expressed by rcHC-HA / PTX3 or IL-23 expressed by macrophages stimulated with LPS in the absence of isolated nHC-HA / PTX3 complex. Lower when rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex is contacted with macrophages stimulated with
(Iv) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex increases the expression of IL-10 in macrophages stimulated with LPS and is expressed by macrophages stimulated with LPS IL-10 values were compared to those of IL-10 expressed by macrophages stimulated with LPS in the absence of rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complexes. Higher when rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex is contacted with macrophages stimulated with
(V) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex promotes apoptosis of neutrophils stimulated with LPS, and in samples of neutrophils stimulated with LPS The number of neutrophils stimulated with apoptotic LPS was stimulated with apoptotic LPS in the sample in the absence of rcHC-HA / PTX3 or the isolated nHC-HA / PTX3 complex. Compared to the number of neutrophils, the sample is more in contact with the rcHC-HA / PTX3 complex,
(Vi) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex promotes phagocytosis of apoptotic neutrophils and stimulates with LPS in samples of apoptotic neutrophils The number of apoptotic neutrophils phagocytosed by activated or resting macrophages and LPS-stimulated macrophages is determined by LPS-stimulated macrophages in the sample in the absence of the rcHC-HA / PTX3 complex. 49. The rcHC-HA / PTX3 complex according to any of claims 46 to 48, or more when the sample contacts the rcHC-HA / PTX3 complex, compared to the number of neutrophils phagocytosed, or 62. The isolated nHC-HA / PTX3 complex according to any one of claims 49 to 61. (I) the rcHC-HA / PTX3 complex or the isolated nHC-HA / PTX3 complex decreases the level of IL-12p40 mRNA or IL-12p40 protein;
(Ii) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex decreases the level of IL-12p70 protein;
(Iii) rcHC-HA / PTX3 complex, or isolated nHC-HA / PTX3 complex, decreases the level of IL-23 mRNA or IL-23 protein;
(Iv) rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex increases the level of IL-10 mRNA or IL-10 protein, or
The rcHC-HA / PTX3 complex according to any one of claims 46 to 48 or the isolated nHC according to any one of claims 49 to 61, which is any combination of (i) to (iv) -HA / PTX3 complex.   The complex facilitates the binding of LPS-stimulated macrophages until it reaches at least the same level as native HC-HA / PTX3 (nHC-HA / PTX3) isolated from human amniotic membrane, 49. The rcHC of any of claims 46 to 48, comprising contacting LPS-stimulated macrophages with a rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex immobilized on a support. -HA / PTX3 complex. A method for inducing macrophage M2 polarization comprising:
contacting the LPS-stimulated macrophages with a rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex.   The rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex is the rcHC-HA / PTX3 complex according to any of claims 46 to 48, or the claims 49 to 61. 68. The method of claim 66, wherein the isolated nHC-HA / PTX3 complex. contacting the LPS-stimulated macrophages with the rcHC-HA / PTX3 or isolated nHC-HA / PTX3 complex,
(I) reducing the level of IL-12p40 expressed by macrophages,
(Ii) reducing the level of IL-12p70 expressed by macrophages;
(Iii) reduce the level of IL-23 expressed by macrophages, or
(Iv) increasing the level of IL-10 expressed by macrophages;
(V) induces apoptosis of neutrophils stimulated with LPS,
(Vi) promotes phagocytosis of apoptotic neutrophils, or
68. The method of claim 66 or 67, comprising any combination of (i) to (vi).   The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-HA / PTX3 complex according to any of claims 49 to 61, and a pharmaceutically acceptable A pharmaceutical composition comprising various excipients.   70. The pharmaceutical composition of claim 69, further comprising fibronectin, collagen, laminin, keratin, fibrin, fibrinogen, hyaluronic acid, heparan sulfate, chondroitin sulfate, or combinations thereof.   71. The pharmaceutical composition of claim 69 or 70, further comprising an anti-inflammatory agent, anti-scar agent, antitumor agent, chemotherapeutic agent, immunosuppressive agent, cytotoxic agent, antibacterial agent, or a combination thereof.   72. The pharmaceutical composition according to any one of claims 69 to 71, wherein the pharmaceutical composition is a solution, suspension, gel, powder, ointment, tablet, capsule, or aerosol.   73. A pharmaceutical composition according to claim 72, wherein the gel is a cross-linked gel or a liposome.   73. A pharmaceutical composition according to claim 72, wherein the gel is a crosslinked hyaluronan hydrogel. 68. The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the simple substance according to any of claims 49 to 61 for preventing or reversing scar formation or fibrosis in tissue. Use of an effective amount of released nHC-HA / PTX3 complex comprising:
A tissue is added to an effective amount of the rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-HA / PTX3 complex according to any of claims 49 to 61. Use, including the step of contacting.   76. Use according to claim 75, wherein the scar is a dermatitis scar, a keloid scar, a spastic scar, a hypertrophic scar, a scar derived from acne.   62. The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-HA according to any of claims 49 to 61 for preventing or reducing inflammation in a subject. Use of an effective amount of / PTX3 complex.   78. Use according to claim 77, wherein the inflammation is acute inflammation or chronic inflammation.   79. Use according to claim 77 or 78, wherein the inflammation is a macrophage-mediated inflammatory disease, a Th-17-mediated immune disorder, or a T cell-mediated inflammatory disease.   80. Use according to any of claims 77 to 79, wherein the inflammation is associated with an autoimmune disease, allergy, leukocyte deficiency, infection, graft versus host disease, tissue transplant rejection, or a combination thereof.   80. Use according to any of claims 77 to 79, wherein the inflammation is associated with rheumatoid arthritis.   80. The use according to any of claims 77 to 79, wherein the inflammation is associated with conjunctivitis, keratitis, blepharitis, blephar conjunctivitis, scleritis, epidural inflammation, uveitis, retinitis, or choroiditis.   80. Use according to any of claims 77 to 79, wherein the inflammation is associated with myocardial infarction, stroke, endotoxin shock, or sepsis.   80. Use according to any of claims 77 to 79, wherein the inflammation is associated with atherosclerosis.   80. Use according to any of claims 77 to 79, wherein the subject is suffering from cancer.   86. Use according to any of claims 77 to 85 for administration in conjunction with an additional anti-inflammatory agent to a subject.   Additional anti-inflammatory agents include anti-TGF-β antibody, anti-TGF-β receptor blocking antibody, anti-TNF antibody, anti-TNF receptor blocking antibody, anti-IL1β antibody, anti-IL1β receptor blocking antibody, anti-IL2 antibody, anti-IL2 Receptor blocking antibody, anti-IL6 antibody, anti-IL6 receptor blocking antibody, anti-IL12 antibody, anti-IL12 receptor blocking antibody, anti-IL17 antibody, anti-IL17 receptor blocking antibody, anti-IL23 antibody, or anti-IL23 receptor blocking antibody 90. Use according to claim 86, selected from among the following.   88. Use according to claim 87, wherein the type 1 interferon is IFN- [alpha] or IFN- [beta].   62. The rcHC-HA / PTX3 complex of any of claims 46 to 48 or the isolated nHC- of any of claims 49 to 61 for treating a skin wound or ulcer in a subject. Use of an effective amount of HA / PTX3 complex.   90. Use according to claim 89, wherein the skin wound or ulcer is non-healing.   64. The rcHC-HA / PTX3 complex of any of claims 46 to 48 or the isolated nHC- of any of claims 49 to 61 for promoting or causing bone formation in a subject. Use of an effective amount of HA / PTX3 complex.   92. The use of claim 91, wherein the subject suffers from arthritis, osteoporosis, alveolar bone degradation, Paget's disease, or a bone tumor.   62. The rcHC-HA / PTX3 complex of any of claims 46 to 48 or the isolated of any of claims 49 to 61 for preventing or reducing undesirable angiogenesis in a subject. Use of an effective amount of nHC-HA / PTX3 complex.   94. Use according to claim 93, wherein undesirable angiogenesis is associated with wet age-related macular degeneration (wARMD) or diabetic proliferative retinopathy.   94. Use according to claim 93, wherein the unwanted angiogenesis is associated with cancer.   94. Use according to claim 93, wherein the subject suffers from a solid tumor.   99. Use according to any of claims 95 or 96 for administration with an anti-cancer treatment.   98. The use of claim 97, wherein the anti-cancer treatment comprises administration of an anti-tumor agent, cytotoxic agent, anti-angiogenic agent, chemotherapeutic agent, or radiation therapy.   The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-- according to any of claims 49 to 61 for preventing transplant rejection in a transplant recipient. Use of an effective amount of HA / PTX3 complex.   99. Use according to claim 99 for administration before, after or during a transplant procedure.   101. Use according to claim 99 or 100 for administration in combination with an immunosuppressive agent.   62. A method of causing expansion of a stem cell of a subject, wherein the rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the effective amount of any of the rcHC-HA / PTX3 complex or claim 49 to 61. A method comprising the step of contacting stem cells in vitro with an isolated nHC-HA / PTX3 complex.   68. The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the simple substance according to any of claims 49 to 61, in combination with a therapeutic cell, in order to administer cell therapy to a subject. Use of an effective amount of released nHC-HA / PTX3 complex.   104. The use of claim 103, further comprising contacting the damaged cell with the rcHC-HA / PTX3 complex or the isolated nHC-HA / PTX3 complex and the therapeutic cell.   104. The rcHC-HA / PTX3 complex, or the isolated nHC-HA / PTX3 complex, and the therapeutic cell are formulated in one composition or in separate compositions. Use of description.   104. Use according to claim 103, wherein the therapeutic cells are encapsulated in microcapsules.   105. Use according to claim 104, wherein the rcHC-HA / PTX3 complex or isolated nHC-HA / PTX3 complex binds to a microcapsule.   108. Use according to any of claims 103 to 107, wherein the therapeutic cells are stem cells.   109. Use according to claim 108, wherein the therapeutic cells are adult stem cells or induced pluripotent stem cells.   109. Use according to claim 108, wherein the therapeutic cells are limbal epithelial progenitor cells, limbal stromal niche cells, umbilical cord stem cells, amniotic stem cells, or adipose stem cells.   109. Use according to claims 103 to 108, wherein the therapeutic cells are differentiated cells.   109. Use according to claims 103 to 108, wherein the therapeutic cell is an insulin producing cell.   119. Use according to claim 112, wherein the insulin producing cells are islet cells.   114. Use according to claim 112 or 113, wherein the subject suffers from type 1 diabetes.   62. The rcHC-HA / PTX3 complex of any of claims 46 to 48 or the isolated nHC- of any of claims 49 to 61 for causing or promoting tissue regeneration in a subject. Use of an effective amount of HA / PTX3 complex.   119. Use according to claim 115, wherein the tissue is bone or gums, corneal tissue, or conjunctival tissue.   117. Use according to claim 115 or 116 for administration in combination with a therapeutic cell or tissue graft.   118. Use according to claim 117, wherein the tissue graft is an allograft or an autograft.   The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the claim according to any one of claims 49 to 61 for suppressing or reducing the amount of M1 adipose tissue macrophage in a subject. Use of an effective amount of isolated nHC-HA / PTX3 complex.   120. Use according to claim 119, wherein the subject is diagnosed with obesity or insulin resistance.   62. The rcHC-HA / PTX3 complex according to any of claims 46 to 48 or the isolated nHC-HA according to any of claims 49 to 61 for treating conjunctival laxity in a subject. Use of an effective amount of / PTX3 complex.   A substrate suitable for culturing cells and an rcHC-HA / PTX3 complex according to any of claims 46 to 48 or an isolated nHC-HA / according to any of claims 49 to 61. A cell culture comprising a PTX3 complex.   123. The cell culture of claim 122, wherein the rcHC-HA / PTX3 complex or nHC-HA / PTX3 complex is immobilized on a substrate.   A rcHC-HA / PTX3 complex according to any of claims 46 to 48 or a substrate coated with the isolated nHC-HA / PTX3 complex according to any of claims 49 to 61. apparatus.   Substrates are stents, joints, screws, rods, pins, plates, clasps, shunts, forceps, clips, sutures, suture anchors, electrodes, catheters, leads, grafts, bandages, pacemakers, pacemaker housings Cardiovascular defibrillator, defibrillator housing, defibrillator, defibrillator housing, orthosis, ear drainage tube, ocular implant, orthopedic device, intervertebral disc, bone substitute At least one of an article, an anastomosis device, a perivascular packaging material, a colon fistula bag attachment device, a hemostatic barrier, a vascular graft, a vascular support, a tissue adhesive, a tissue sealant, a tissue scaffold, and an intraluminal device 125. The medical device of claim 124, comprising:   125. The medical device of claim 124, wherein the substrate is a microcapsule, a nanoparticle, or a bead.   127. The medical device of claim 126, wherein the microcapsule includes stem cells.   125. The medical device of claim 124, wherein the substrate is a contact lens.   125. The medical device of claim 124, wherein the substrate is a surgical graft or a brace.   130. The medical device of claim 129, wherein the graft or brace is an artificial joint, bone implant, suture, or stent.   131. The medical device according to claim 130, wherein the artificial joint is an artificial hip joint, an artificial knee, an artificial shoulder joint, or an artificial knee.   131. The medical device of claim 130, wherein the stent is a coronary stent, ureteral stent, urethral stent, prostate stent, esophageal stent, or bone stent.   135. The medical device according to any of claims 124 to 132, wherein the rcHC-HA / PTX3 complex or the isolated nHC-HA / PTX3 complex inhibits bacterial biofilm formation. A method for modulating macrophage activity comprising:
49. An amount according to any of claims 46 to 48, in an amount sufficient to (i) reduce or inhibit IL-12 or IL-23 expression, or (ii) promote IL-10 expression. 62. A method comprising contacting a macrophage with the rcHC-HA / PTX3 complex of the above or the isolated nHC-HA / PTX3 complex according to any one of claims 49 to 61.   135. The method of claim 134, wherein the macrophages are stimulated with a pro-inflammatory mediator.   138. The method of claim 135, wherein the pro-inflammatory mediator is lipopolysaccharide (LPS), tumor necrosis factor alpha (TNF-α), interferon gamma (IFNγ), or a combination thereof.   137. The method according to any of claims 134 to 136, wherein the rcHC-HA / PTX3 complex or the isolated nHC-HA / PTX3 complex contacts macrophages in vitro.   A rcHC-HA / PTX3 complex according to any of claims 46 to 48 or an isolated nHC-HA / PTX3 complex or composition according to any of claims 49 to 61. A kit comprising a device and optionally instructions for administration. A method for inducing or maintaining cellular pluripotency comprising:
A method comprising culturing cells comprising an nHC-HA / PTX3 complex or rcHC-HA / PTX3 complex, thereby inducing or maintaining cellular pluripotency.   140. The method of claim 139, wherein the cell heterologously expresses a protein selected from Sox2, myc, Oct4, and KLF4.   140. The method of claim 139, wherein the cell heterologously expresses one, two, or three proteins selected from Sox2, myc, Oct4, and KLF4.   140. The method of claim 139, wherein the nHC-HA / PTX3 complex or rcHC-HA / PTX3 complex is immobilized.   140. The method of claim 139, wherein the cell is an adult differentiated cell.   140. The method of claim 139, wherein the cell is a fibroblast.   145. The method of claim 144, wherein the cell is a human corneal fibroblast.   140. The method of claim 139, wherein the cell is an adult stem cell or an induced pluripotent stem cell.   140. The method of claim 139, wherein the cells are limbal epithelial progenitor cells, limbal stromal niche cells, umbilical cord stem cells, amniotic stem cells, or adipose stem cells.   The nHC-HA / PTX3 complex or the rcHC-HA / PTX3 complex is an rcHC-HA / PTX3 complex according to any one of claims 46 to 48 or a single substance according to any one of claims 49 to 61. 148. A method according to any of claims 139 to 147, which is a released nHC-HA / PTX3 complex.